Silent coronary artery disease in diabetes--a feature of autonomic neuropathy or accelerated atherosclerosis?

Diabetologia. 2001 Feb;44(2):259-66. doi: 10.1007/s001250051609.


Asymptomatic coronary artery disease and myocardial infarctions are common in diabetic subjects. The available clinical and epidemiological data suggest that the increased incidence of asymptomatic myocardial infarctions and coronary artery disease in diabetic patients mainly reflects accelerated coronary atherosclerosis and the proportion of silent disease relative to symptomatic disease or episodes is not increased in diabetes. In spite of the theoretical background, there is no convincing clinical or epidemiological evidence that diabetic autonomic neuropathy plays a major part in the lack of ischaemic pain. This is not surprising because the mechanisms of silent myocardial ischaemia are complex and controversial even without diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arteriosclerosis / complications*
  • Autonomic Nervous System Diseases / complications*
  • Coronary Disease / diagnosis*
  • Coronary Disease / etiology*
  • Diabetes Complications*
  • Diabetic Neuropathies / complications*
  • Heart / innervation
  • Humans
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / etiology
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / etiology
  • Pain
  • Sympathetic Nervous System / physiopathology