[ silent myocardial ischemia of diabetics: screening and risk factors]

ABSTRACT

Silent myocardial ischemia [SMI] is a clinical form of coronary artery insufficiency. It is more frequent in diabetic subjects and has an unfavourable prognosis. The aim of our study is to evaluate the prevalence of SMI in diabetic subjects and to determine its risk factors. This is a prospective study of 114 diabetic outpatients free from known coronary artery disease and clinical and electric symptoms of coronary insufficiency. All subjects underwent an exercise electrocardiogram [EE]; a coronary angiography was indicated in the positive cases. The prevalence of SMI was 12.3%. The subjects with positive EE were older [58.0 +/- 7.8 vs 52.0 +/- 10.5 years, p<0.05], more frequently of male sex [M/W =7/7 vs 28/72, p<0.02], had a higher duration of diabetes [p<0.001], a higher body mass index [28.1 +/- 3.4 vs 26.2 +/- 2.8 Kg/m2, p<0.05] and were more frequently hypertensive [8/14 vs 24/100, p<0.05]. In conclusion, screening for SMI must primarily target elderly overweighted male subjects with a long duration of diabetes and at least one other vascular risk factor