What question did this study set out to answer?

To determine whether angina reliably indicates exertional myocardial ischemia in patients with diabetes compared to those without diabetes.

February 1, 1988Annals of Internal Medicine

Angina and Exertional Myocardial Ischemia in Diabetic and Nondiabetic Patients: Assessment by Exercise Thallium Scintigraphy

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Why the study?

Does diabetes mellitus reduce the likelihood of experiencing angina during exertional myocardial ischemia?

Population

100 consecutive patients, all with ischemia on exercise thallium scintigraphy

Comparison

Diabetes mellitus vs No diabetes mellitus

Design

Cross-sectional

Authors

RNRichard W. NestoGeneral / Preventive / Lipids

Discussion

Member takes

Implication

Angina may underestimate ischemia in diabetes; leaves open whether routine objective testing improves outcomes.

Key Points

To determine whether angina reliably indicates exertional myocardial ischemia in patients with diabetes compared to those without diabetes.
Evaluated 50 consecutive diabetic patients and 50 consecutive nondiabetic patients with documented ischemia using exercise thallium scintigraphy.
Assessed exercise treadmill parameters, extent of ischemia and infarction, and diabetic microvascular complications including retinopathy, nephropathy, and peripheral neuropathy.
Angina during exertional ischemia occurred in significantly fewer diabetic patients than nondiabetic patients (14 vs 34 patients).
The frequency of diabetic complications, including retinopathy, nephropathy, and peripheral neuropathy, did not differ between diabetic patients with and without angina.

Structured PICO

Does diabetes mellitus reduce the likelihood of experiencing angina during exertional myocardial ischemia?

Population

100 consecutive patients (50 with diabetes mellitus and 50 without diabetes), all with ischemia on exercise thallium scintigraphy

Intervention

Diabetes mellitus

Comparator

No diabetes mellitus

Outcome

Presence of angina during exertional ischemiapatient reported

Angina is an unreliable marker for exertional myocardial ischemia in diabetic patients, highlighting the need for periodic objective assessments like imaging.

Cite This Study

Richard W. Nesto (1988) studied this question.

synapsesocial.com/papers/6a7e2de49408b4785c8f4323 https://doi.org/10.7326/0003-4819-108-2-170

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Angina and Exertional Myocardial Ischemia in Diabetic and Nondiabetic Patients: Assessment by Exercise Thallium Scintigraphy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Angina and Exertional Myocardial Ischemia in Diabetic and Nondiabetic Patients: Assessment by Exercise Thallium Scintigraphy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider