The aim of the study was to determine the prevalence of silent myocardial ischemia in type 2 diabetic patients without any clinical and/or laboratory findings of myocardial ischemia and to examine the related factors for silent myocardial ischemia.
One hundred and sixteen (82 female, 34 male) type 2 diabetic patients with a disease duration of 5-20 years were included in the study. All patients underwent stress and resting myocardial perfusion single-photon emission computed tomographic study with 99mTc-MIBI. Coronary angiography was performed on patients with ischemia established by myocardial perfusion single-photon emission computed tomography.
Ischemia was determined in 18 (15.5%) patients by myocardial perfusion singlephoton emission computed tomogr aphy and among 17 patients upon whom coronary angiography was performed 11 had coronary stenosis (>50%). Thus the prevalence of silent myocardial ischemia was 9.6%. The positive predictive value of myocardial perfusion single-photon emission computed tomography was calculated as 64.7% (77.8% for men and 50% for women). The mean diabetes duration of the patients with coronary stenosis was over 10 years. Significant relations were found between silent myocardial ischemia and male sex, high HbA 1C level and retinopathy.
Patients (especially of the male gender and with a diabetes duration of over 10 years) with poorly controlled diabetes mellitus and/or with retinopathy should be screened for silent myocardial ischemia.
Keywords: Silent myocardial ischemia, type 2 diabetes mellitus, HbA 1C, retinopathy