الفهرس 
Silent myocardial ischemiaOnly 14 pages are availabe for public view
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Abstract
Epidemiological evidence suggests that patients with diabetes mellitus are at increased risk for CAD, silent ischemia is reported to be more frequent in diabetic populations.
So the aim of our study is to evaluate the prevalence of silent myocardial ischemia in diabetic and non diabetic patients with assessed CAD.
The present study included eighty patients, their age ranged from 30 to 75 years old, mean value 51.8±8.52, among these patients included in this study 59 were males (73.8%) and 21 were females (26.3%). Thirty three patients were smokers (41.3%) and seven patients were ex-smokers (8.8%). Forty patients (50%) gave family history of ischemic heart disease, thirty eight patients (47.5%) gave history of myocardial infarction and all patients (100%) gave history of angina. Forty nine patients (61.3%) are hypertensive.
These patients classified into diabetic group and non diabetic group. All diabetic patients had type 2 diabetes, and for a duration ranging from 5 to 35 years, mean value 19.1±7.52.
Every patient was subjected to complete history taking, resting ECG, stress ECG and coronary angiography.
Patients classified according to results of exercise ECG into four groups:
5- Group1: 28 patients (35%), showed no ST depression or chest pain during exercise test, 10 patients of them (35.7%) were diabetic and 18 patients (64.3%) were non diabetic.
6- Group2: two patients (5%) which were diabetic showed chest pain without stress ST depression (Only pain).
7- Group3: 26 patients (32.5%) showed stress ST depression without chest pain (silent ischemia), 18 patients of them (69.2%) were diabetic and 8 patients (30.8%) were non diabetic.
8- Group4: 24 patients (30%) showed ST depression and chest pain during exercise test (symptomatic ischemia), 10 patients of them (41.7%) were diabetic and 14 patients (58.3%) were non diabetic.
This means that prevalence of silent ischemia in diabetics (45%), which is more than that in non diabetics (20%), P value=0.017. It was found that the prevalence of SMI in diabetic males (51.9%) was more than that in diabetic females (31.8%).
All patients underwent coronary angiography (100%) and all of them have significant coronary artery disease (50 % stenosis or more), with the following distribution:
- Twenty eight patients (35%) exhibited single vessel disease, thirteen of them (46.4%) were diabetic and fifteen (53.6%) were non diabetic.
- Thirty seven patients (46.3%) exhibited two vessel disease, fifteen of them (40.5%) were diabetic and twenty two (59.5%) were non diabetic.
- Fifteen patients (18.8 %) exhibited three vessel disease, twelve of them (80 %) were diabetic and three (20%) were non diabetic.
The development of silent ischemia does not appear to be related to age or duration of DM, but appears to be related to gender, history of MI, history of IHD, association of other risk factors like HTN and number of vessels affected.