Study of silent myocardial ischemia using exercise stress test among diabetic and non-diabetic patients with documented coronary artery disease

Introduction: Prospective studies have documented an increased likelihood of sudden cardiac death and unrecognized myocardial infarction in patients with diabetes. Aim of the work: To study silent myocardial ischemia using exercise stress test among diabetic and non-diabetic patients with angiographically documented coronary artery disease. Patients and methods: Patients with contra-indications to exercise test were excluded.All patients were subjected to treadmill test using modified Bruce protocol & were considered to have silent ischemia if ECG shows ischemic changes without chest pain. Statistics: Data were collected & analyzed statistically. Results: The study included 80 patients with CAD (40 diabetics & 40 non-diabetics).Their mean age was 58. years old, including males (73.8%).According to stress test patients were classified:. 1-Group 1: 28 patients (35%), showed no ST depression no chest pain during exercise test, 10 patients of them (35.7%) were diabetic.2-Group 2: two patients (2.5%) who were diabetic showed chest pain without stress induced ST depression (only pain).3-Group 3: 26 patients (32.5%) showed stress ST depression without chest pain (silent ischemia), 18 patients of them (69.2%) were diabetic.4-Group 4: 24 patients (30%) showed ST depression and chest pain during exercise test (symptomatic ischemia), 10 patients of them (41.7%) were diabetic.All patients underwent coronary angiography (100%) and all of them had significant coronary artery disease (more than 50% stenosis). Conclusion: Diabetics with coronary artery disease have a higher prevalence of silent myocardial ischemia than non-diabetics. © 2012.