Objective: To evaluate the prevalence of silent myocardial ischemia in patients with non-insulin dependent diabetes mellitus with no symptoms of cardiac disease.
Setting: Tertiary care center.
Patients: 60 patients with non-insulin dependent diabetes mellitus; mean age 58 +/- 12 years, who had no symptoms of angina or any other clinical evidence of coronary artery disease and normal resting electrocardiogram. A control group of 57 healthy volunteers, matched for age and sex were included.
Measurements: All patients underwent a 24 hour electrocardiographic Holter monitoring test. An ischemic episode was defined as depression of the ST segment > or = 1 mm for > or = 1 min.
Results: 10 of the 60 diabetic (17%) were found to have silent myocardial ischemia and only 3/57 (5%) was detected in the controls. In a two years follow up, four diabetics developed symptomatic angina pectoris.
Conclusions: Silent myocardial ischemia in asymptomatic diabetics occurs frequently; a lack of symptoms does not discard a myocardial ischemia, and the Holter recordings may help in its detection.