[Silent myocardial ischemia in type 2 diabetes. Predictive value of intima-media thickness].
BACKGROUND
The carotid intima-media thickness (CIT) is correlated with the prevalence of cardiovascular diseases. We studied the relationship between the thickness of the carotid intima-media and the existence of myocardial ischemia, detected by scintigraphy in a population of type 2 diabetic patients without coronary antecedents.


METHODS
We conducted repeated Doppler measurements of the CIT of primitive carotid arteries in 52 diabetic patients aged 49 to 75. All these asymptomatic patients, without coronary antecedents, diabetic for more than 10 years and exhibiting at least one cardiovascular risk factor, had undergone myocardial scintigraphy.


RESULTS
The CIT was greater in the group with positive scintigraphies and is the best predictive factor of the presence of ischemia. For a CIT value < 0.55 mm, the negative predictive value of the CIT was of 77% with 80% sensitivity; in non-smokers the predictive negative value increased to 92% with 95% sensitivity.


CONCLUSIONS
Reliable and reproducible, measurement of CIT correlates well with myocardial scintigraphy and could be an interesting alternative screening policy in asymptomatic, type 2 diabetic patients.
Boucher
B
B
Service de Médecine Interne, CHU Saint-Etienne, 42055 Saint-Etienne.
Cerisier
A
A
Bouchou
K
K
Brulport-Cerisier
V
V
Charmion
S
S
Estour
B
B
Boissier
C
C
Cathébras
P
P
D000368:Aged; D002339:Carotid Arteries / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000473:pathology; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000473:pathology; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000473:pathology; D011877:Radionuclide Imaging; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography