Key result
Silent myocardial ischemia is more common in diabetic patients than non-diabetics and carries a similar adverse prognosis to symptomatic ischemia, suggesting high-risk asymptomatic diabetic patients may benefit from routine screening.
Asymptomatic high-risk diabetic patients may benefit from routine screening for silent ischaemia, as it carries a similar prognosis to symptomatic ischaemia.
May warrant screening consideration in high-risk asymptomatic diabetics; leaves open confirmation in randomized trials.
Coronary artery disease (CAD) represents the leading cause of death in diabetic patients. Silent myocardial ischaemia more often occurs in diabetics than in non-diabetics. It has been well recognised that silent myocardial ischaemia is not different from symptomatic ischaemia with respect to prognosis and adverse events. Asymptomatic high-risk diabetic patients therefore might benefit from routine screening for silent ischaemia and risk stratification; furthermore, silent ischaemia has to be treated accordingly.
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Zellweger et al. (2001) conducted a review in Silent coronary artery disease in diabetes mellitus. Screening and management of silent ischemia was evaluated. Silent myocardial ischemia is more common in diabetic patients than non-diabetics and carries a similar adverse prognosis to symptomatic ischemia, suggesting high-risk asymptomatic diabetic patients may benefit from routine screening.
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