Diabetes mellitus and Silent Myocardial Ischemia

2015 ◽  
pp. 297-303 ◽  
Author(s):  
Joseph S. Alpert ◽  
Stuart R. Chipkin ◽  
Neil Aronin
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Ischemia ◽  
Silent Myocardial Ischemia

scholarly journals Diabetes Mellitus with Silent Myocardial Ischemia: A Single-Center Cross-Sectional Study of Karachi, Pakistan

2021 ◽  
pp. 56-60
Author(s):  
Muhammad Zohaib Siddiq ◽  
Shahid Hussain Memon ◽  
Anwar Ali ◽  
Tabassum Almas ◽  
Atiya Razzaq ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Ischemia ◽  
Cross Sectional Study ◽  
Silent Myocardial Ischemia ◽  
Study Patient ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
St Segment ◽  
History Of

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.

scholarly journals Silent myocardial ischemia screening in patients with diabetes mellitus

2007 ◽  
Vol 51 (2) ◽  
pp. 285-293 ◽  
Author(s):  
Olivier Barthelemy ◽  
Claude Le Feuvre ◽  
José Timsit
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Myocardial Ischemia ◽  
Stress Test ◽  
Arterial Disease ◽  
Myocardial Scintigraphy ◽  
Cardiovascular Complications ◽  
Silent Myocardial Ischemia ◽  
Diabetic Patients ◽  
Maximal Heart Rate

The prevalence of diabetes mellitus is fairly increasing, especially in the developing countries. Diabetes is a major cardiovascular risk factor; it often leads to severe cardiovascular complications, and coronary artery disease (CAD) is the main cause of death in diabetic patients. Silent myocardial ischemia (SMI) is more frequent in diabetic patients. The progress made in detection and treatment of CAD allows reconsidering the screening of SMI, in the hope that early CAD diagnosis leads to a more effective therapy and the decrease of cardiovascular complications and mortality. However, the benefit of systematic SMI screening remains discussed. Current guidelines recommend screening SMI in asymptomatic diabetic patients selected for high cardiovascular risk (i.e. with two or more other cardiovascular risk factors, or peripheral or carotid arterial disease, or proteinuria). ECG stress test can be recommended in first intention if maximal heart rate can be achieved. For patient with inconclusive ECG stress test, myocardial scintigraphy seems more accurate than stress echocardiography. Coronary angiogram should be performed in case of positive stress test. Further evaluations of systematic screening have to be conducted on broad randomized trial.

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