BACKGROUND: Diabetic patients have an increased prevalence of atherosclerosis and coronary artery disease. They may also experience higher morbidity and mortality after acute coronary syndrome compared with non-diabetic subjects. AIM: The objective of this study was to determine the presence of silent myocardial ischaemia by treadmill test in asymptomatic diabetic patients and to compare it with age- and sex-matched subjects without diabetes mellitus. METHODS: The study design was cross-sectional and the setting was a tertiary care centre. Fifty (42 males, 8 females) asymptomatic patients with diabetes in the age group of 30-70 years were included in the study group and 30 (24 males, 6 females) non-diabetic subjects of comparable age, sex and physical activity were the control group. They were assessed for the presence of silent ischaemia by a standard treadmill test using the Bruce protocol. RESULTS: Twenty-five of 50 diabetic patients showed a positive response to the exercise stress test, while 7 of 30 controls showed stress test positivity (p < 0.05). The stress test positivity showed a female predilection among diabetic patients (50% in diabetic patients and 16.67% in controls; p < 0.05). Diabetic patients with a positive stress test showed higher prevalence of hypertension (36%) and dyslipidaemia (84%) compared with diabetic patients with a negative stress test (12% and 28%, respectively) [p < 0.001]. The controls showed a better exercise capacity compared with diabetic patients; diabetic patients with a negative stress test had better exercise capacity than those with a positive stress test. CONCLUSIONS: The treadmill test is a useful, specific, cost-effective, non-invasive tool for detection of silent myocardial ischaemia in asymptomatic diabetic patients.
BACKGROUND:Diabeticpatients have an increased prevalence of atherosclerosis and coronary artery disease. They may also experience higher morbidity and mortality after acute coronary syndrome compared with non-diabetic subjects. AIM: The objective of this study was to determine the presence of silent myocardial ischaemia by treadmill test in asymptomatic diabeticpatients and to compare it with age- and sex-matched subjects without diabetes mellitus. METHODS: The study design was cross-sectional and the setting was a tertiary care centre. Fifty (42 males, 8 females) asymptomatic patients with diabetes in the age group of 30-70 years were included in the study group and 30 (24 males, 6 females) non-diabetic subjects of comparable age, sex and physical activity were the control group. They were assessed for the presence of silent ischaemia by a standard treadmill test using the Bruce protocol. RESULTS: Twenty-five of 50 diabeticpatients showed a positive response to the exercise stress test, while 7 of 30 controls showed stress test positivity (p < 0.05). The stress test positivity showed a female predilection among diabeticpatients (50% in diabeticpatients and 16.67% in controls; p < 0.05). Diabeticpatients with a positive stress test showed higher prevalence of hypertension (36%) and dyslipidaemia (84%) compared with diabeticpatients with a negative stress test (12% and 28%, respectively) [p < 0.001]. The controls showed a better exercise capacity compared with diabeticpatients; diabeticpatients with a negative stress test had better exercise capacity than those with a positive stress test. CONCLUSIONS: The treadmill test is a useful, specific, cost-effective, non-invasive tool for detection of silent myocardial ischaemia in asymptomatic diabeticpatients.
Authors: R J Gibbons; G J Balady; J W Beasley; J T Bricker; W F Duvernoy; V F Froelicher; D B Mark; T H Marwick; B D McCallister; P D Thompson; W L Winters; F G Yanowitz; J L Ritchie; R J Gibbons; M D Cheitlin; K A Eagle; T J Gardner; A Garson; R P Lewis; R A O'Rourke; T J Ryan Journal: J Am Coll Cardiol Date: 1997-07 Impact factor: 24.094
Authors: E Marín Huerta; I Rayo; J I Lara; L Cuéllar; H de la Calle; J Romero; A del Río; A Muela; V Aza Journal: Rev Esp Cardiol Date: 1989-10 Impact factor: 4.753
Authors: Christina G de Souza E Silva; Barry A Franklin; Daniel E Forman; Claudio Gil S Araújo Journal: J Geriatr Cardiol Date: 2016-02 Impact factor: 3.327