Identification of Silent Myocardial Ischemia in Patients with Long-Term Type 1 and Type 2 Diabetes

Dominika Rokicka, Anna Bożek, Marta Wróbel, Alicja Nowowiejska-Wiewióra, Aleksandra Szymborska-Kajanek, Tomasz Stołtny, Mariusz Gąsior and Krzysztof Strojek
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Dominika Rokicka: Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
Anna Bożek: Outpatient Clinic for Patients with Diabetes, 41-800 Zabrze, Poland
Marta Wróbel: Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
Alicja Nowowiejska-Wiewióra: 3rd Department of Cardiology, Faculty of Medical Sciences Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
Aleksandra Szymborska-Kajanek: Outpatient Clinic for Patients with Diabetes, 41-800 Zabrze, Poland
Tomasz Stołtny: District Hospital of Orthopaedics and Trauma Surgery in Piekary Śląskie, 41-940 Piekary Śląskie, Poland
Mariusz Gąsior: 3rd Department of Cardiology, Faculty of Medical Sciences Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
Krzysztof Strojek: Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland

IJERPH, 2022, vol. 19, issue 3, 1-10

Abstract: (1) Background: This study aimed to analyze epidemiological data to identify risk factors for silent myocardial ischemia in patients with long-term type 1 and type 2 diabetes. (2) Methods: An analysis was performed on 104 patients with long-term type 1 and type 2 diabetes who had not previously been diagnosed with cardiovascular disease. During hospitalization, patients were subjected to a standard ECG exercise test on a treadmill. If the test could not be performed or the result was uncertain, a pharmacological exercise test with dobutamine was performed. In the case of a positive exercise ECG test or a positive dobutamine test, the patient underwent coronary angiography. (3) Results: Atherosclerotic lesions were found in 24 patients. Patients with silent ischemia were significantly older and had a lower mean left ventricular ejection fraction and a higher incidence of carotid atherosclerosis. The presence of microvascular complications did not increase the risk of silent ischemia. (4) Conclusions: Silent heart ischemia is more common in type 2 than type 1 diabetes. Predisposing factors include older age, coexistence of carotid atherosclerosis, lower left ventricular ejection fraction, and smoking in patients with type 1 diabetes. Concomitant microvascular complications are not a risk factor.

Keywords: type 1 diabetes; type 2 diabetes; silent myocardial ischemia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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