الفهرس 
MACROVASCULAR COMPLICATIONS OF DIABETES MELLITUSOnly 14 pages are availabe for public view
 |  | from | 105 |  |  |
| | | from | 105 | | |
Abstract
Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Patients
By:
Walid Mohamad Sabry El –Tahlawy
M.B.B.Ch.
ABSTRACT
Given the elevated risk of cardiovascular events and the higher prevalence of silent ischemia of coronary artery disease in diabetic patients.
OBJECTIVE: To assess the incidence and risk factors of silent myocardial ischemia in asymptomatic patients with type 2 diabetes.
PATEINT AND METHODS: 30 patients with type 2 diabetes, aged 35-68 years, with no known or suspected coronary artery disease, were assigned to stress-rest technetium-99m sestamibi SPECT myocardial perfusion imaging.
RESULTS:Thirty three (33.3%) of screened patients had perfusion defects suggestive of ischemia. These patients were older with larger duration of uncontrolled diabetes mellitus. Microalbuminuria (80%) was prevalent among patients with silent ischemia. These patients had exercise induced symptoms (60%) and ECG changes (40%) suggestive of ischemia. The risk for silent myocardial ischemia is increased with advanced age, longer duration of diabetes mellitus, as well as smoking and positive family history of IHD. Patients with uncontrolled diabetes mellitus and/or with microalbuminemia are at increased risk for myocardial ischemia. The development of symptoms or the presence of ECG changes during stress test in asymptomatic diabetic patients should warrant a deeper and specific testing for CAD.Male and female with type II diabetes mellitus are under comparable risk for CAD.
CONCLUSION: In light of the results of the present study we concluded that: Silent myocardial ischemia was found in 33.3% of diabetic patients. The risk for silent myocardial ischemia is increased with advanced age, longer duration of diabetes mellitus, as well as smoking and positive family history of IHD. Patients with uncontrolled diabetes mellitus and/or with microalbuminemia are at increased risk for myocardial ischemia. The development of symptoms or the presence of ECG changes during stress test in asymptomatic diabetic patients should warrant a deeper and specific testing for CAD. Male and female with type II diabetes mellitus are under comparable risk for CAD.