Comparison of prevalence of unrecognized myocardial infarction and of silent myocardial ischemia detected by a treadmill exercise sestamibi stress test in patients with versus without diabetes mellitus.
We investigated, in 287 patients with diabetes (71% men; mean age 63 +/- 8 years) and 292 age- and gender-matched patients with diabetes, the prevalence of unrecognized myocardial infarction (MI) and silent myocardial ischemia (SMI) detected by a treadmill exercise sestamibi stress test. In the patients without a history of MI, MI was diagnosed by treadmill exercise sestamibi stress test in 40 of 217 patients (18%) with diabetes and 16 of 224 patients (7%) without diabetes (p <0.001). In patients with a history of angina, SMI was diagnosed in 35 of 98 patients (36%) with diabetes and 30 of 101 patients (30%) without diabetes (p = NS). In patients without a history of angina, SMI was diagnosed in 62 of 189 patients (33%) with diabetes and 35 of 191 patients (15%) without diabetes (p <0.001). In patients with 2 or 3 risk factors, SMI was diagnosed in 58 of 144 patients (40%) with diabetes and 41 of 142 patients (29%) without diabetes (p <0.005). In patients with 0 or 1 risk factor, SMI was diagnosed in 39 of 143 patients (27%) with diabetes and 24 of 150 patients (16%) without diabetes (p <0.02). In conclusion, patients with diabetes have a higher prevalence of unrecognized MI and a higher prevalence of SMI without a history of angina than patients without diabetes.
DeLuca
Albert J
AJ
Department of Medicine, Cardiology Division, New York Medical College, Valhalla, New York, USA.
Kaplan
Sarah
S
Aronow
Wilbert S
WS
Sandhu
Rasham
R
Butt
Abid
A
Akoybyan
Armais
A
Weiss
Melvin B
MB
D000787:Angina Pectoris / Q000150:complications; D016022:Case-Control Studies; D048909:Diabetes Complications; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis*; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity