Prevalence of myocardial ischaemia among diabetics determined by validated Sinhala version of the WHO Rose angina questionnaire

Abstract

Objectives: The aim of this study was to validate the original version of the Rose Angina Questionnaire (RAQ) and apply it to a group of long standing diabetics in a cross-sectional manner to assess it applicability in clinical settings.

Design Setting: After a face validation and piloting the Part A of the Sinhala translated RAQ (SRAQ-Part A) was given to 47 adult patients who presented with chest pain where the possibility of stable angina was considered in the differential diagnosis. In these patients, the diagnosis of stable angina was confirmed by resting ECG. Patients who had a normal resting ECG or changes non-confirmatory of myocardial ischaemia underwent treadmill examination to detect exercise-induced myocardial ischaemia. PartBof the translatedRAQ(SRAQ-Part B) was given to 68 patients who presented with acute chest pain of less than 24 hours where acute coronary syndrome was considered a possibility. These patients underwent serial ECGs and cardiac enzymes/troponin estimations. The validated SRAQ were administered to a group of diabetics (n = 311) attending medical clinics of Teaching hospital, Karapitiya in a cross-sectional manner to detect the prevalence of stable angina or history of acute coronary syndrome.

Results: Sensitivity, specificity, positive predictive value, and negative predictive values of SRAQ-PartAwere 86.4%, 76%,76%,86%and of part-B were 74.1, 70%, 93.5%, 31.8%, respectively. Of 311 diabetic patients the prevalence of stable angina in this group of patients would be 31% (95% CI = 26-37%). Part B of the questionnaire, 17 answered positively and rest negatively. Of these 17 positives, 16 were likely to have acute coronary disease.

Interpretation: Our analysis shows that the Sinhala translation of the RAQ has an acceptable specificity and sensitivity in detecting either stable angina or acute coronary syndrome. The prevalence of stable angina was 31%among the diabetics selected for this analysis.

Galle Medical Journal, Vol 18: No. 1, March 2013:Page 12-15