Impaired Gastric Emptying Is Associated with a Higher Incidence of Coronary Heart Disease in Subjects with Diabetes

Results: Impaired gastric emptying is observed in long-standing diabetic patients. To date, there is limited information on cardiovascular events in diabetic subjects with upper gastrointestinal (UGI) symptoms according to the presence of impaired gastric emptying. The aim of this study was to identify cardiovascular events after gastric emptying study in diabetic subjects with UGI symptoms. This study collected data from 160 diabetic subjects (23 with type 1 diabetes and 137 with type 2 diabetes) with UGI symptoms who had undergone gastric emptying scintigraphy from 2001 to 2016. We gathered data on the incidence of cardiovascular events (coronary heart disease and ischemic stroke) after gastric emptying study. There were 66 diabetic subjects with normal gastric emptying and 94 diabetic subjects with impaired gastric emptying (58 with delayed gastric emptying and 36 with rapid gastric emptying). During 7.5 years of follow-up, 22.5% of subjects (36/160) developed the cardiovascular events (19 with coronary heart disease, 12 with ischemic stroke and 5 with both). The incidence of coronary heart disease was higher in the subjects with impaired gastric emptying (4.2% at 1 year, 10.6% at 3 years, and 12.7% at 5 years) than those with normal gastric emptying (2.4% at 1 year, 3.6% at 3 years and 4.8% at 5 years p=0.039). Our results showed that diabetic subjects with impaired gastric emptying had higher incidence of coronary heart disease than those with normal gastric emptying. This study may warrant a more careful cardiovascular assessment with a high index of suspicion for possible events in management of diabetic subjects with impaired gastric emptying.