Comparison of Prevalence of Unrecognized Myocardial Infarction and of Silent Myocardial Ischemia Detected by a Treadmill Exercise Sestamibi Stress Test in Patients With Versus Without Diabetes Mellitus

DeLuca, Albert J.; Kaplan, Sarah; Aronow, Wilbert S.; Sandhu, Rasham; Butt, Abid; Akoybyan, Armais; Weiss, Melvin B.

doi:10.1016/j.amjcard.2006.05.026

Cited by 46 publications

(35 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In diabetes, silent coronary artery disease occurs in a varying prevalence, ranging from 12.4% [89], 18% [90], 22% [91] up to 34% [92], depending on age, duration of diabetes and presence of risk factors. Because symptomatic diabetic patients may have a worse prognosis, the detection of disease before acute coronary syndrome events may improve morbidity and mortality.…”

Section: Assessment Of Silent Ischemiamentioning

confidence: 99%

Cardiovascular risk assessment in patients with diabetes

Bertoluci

Rocha

2017

Diabetol Metab Syndr

182

123

View full text Add to dashboard Cite

Although patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD). These patients are not risk equivalent as stated in previous studies. On the contrary, when in the presence of traditional risk factors or evidence of subclinical coronary disease (e.g. high coronary calcium score), the coronary risk is much increased and patients may be classified at a higher-risk category. Recent guidelines do not anymore consider diabetes as a CAD risk equivalent and recommend cardiovascular risk stratification for primary prevention. Stratification of diabetic patients improves accuracy in prediction of subclinical CAD, silent ischemia and future cardiovascular events. Stratification also discriminates higher from lower risk patients who may need intensive statin or aspirin prevention, while avoiding overtreatment in lower risk cases. It may also allow the clinician to decide whether to intensify risk reduction actions through specific newer drugs for glucose control such as SGLT-2 inhibitors or GLP-1 agonists, which recently have shown additional cardiovascular protector effect. This review addresses the assessment of cardiovascular disease risk using traditional and non-traditional cardiovascular risk factors. It also reviews the use of risk calculators and new reclassification tools, focusing on the detection of subclinical atherosclerosis as well as silent ischemia in the asymptomatic patients with diabetes.

show abstract

Section: Assessment Of Silent Ischemiamentioning

confidence: 99%

Cardiovascular risk assessment in patients with diabetes

Bertoluci

Rocha

2017

Diabetol Metab Syndr

182

123

View full text Add to dashboard Cite

show abstract

“…Nonpharmacological interventions include increasing water consumption, avoiding sudden changes in body posture, reducing physical maneuvers that increase intra-abdominal and intrathoracic pressure, use of stockings of the lower extremities, and eating smaller and more frequent meals 5,80. Additionally, certain medications have been associated with orthostatic hypotension and should thus be stopped in patients who are symptomatic, including tricyclic antidepressants, diuretics, and α-adrenoreceptor antagonists 5,9.…”

Section: Treatment Of Canmentioning

confidence: 99%

Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives

Fisher

Tahrani

2017

DMSO

111

View full text Add to dashboard Cite

Cardiac autonomic neuropathy (CAN) is a common and often-underdiagnosed complication of diabetes mellitus (DM). CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease, and morbidity in patients with DM, but despite these significant consequences CAN often remains undiagnosed for a prolonged period. This is commonly due to the disease being asymptomatic until the later stages, as well as a lack of easily available screening strategies. In this article, we review the latest developments in the epidemiology, pathogenesis, diagnosis, consequences, and treatments of CAN in patients with DM.

show abstract

“…Silent ischemia is significantly more frequent in patients with than in those without CAN. Sub-clinical signs of CAN appear earlier than microvascular complications of diabetes [4,5]. Early detection of CAN in diabetic patients and intervention are therefore of prime importance to prevent ventricular arrhythmia, silent ischaemia, sudden cardiac death and stroke.…”

Section: Introductionmentioning

confidence: 98%