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.
Highlights
Cardiovascular complications are the leading cause of death in populations with diabetes
A total of 104 patients participated in the study, including 37 patients with type 2 diabetes (35.6%) and 67 patients with type 1 diabetes (64.4%)
The present study shows that long-term type 1 and type 2 diabetes increase the risk of silent myocardial ischemia
Summary
Cardiovascular complications are the leading cause of death in populations with diabetes. A significant problem in this group of patients is the form of ischemic heart disease, which in the absence of clinical signs, does not allow for the implementation of appropriate diagnostic and therapeutic procedures to reduce the risk of acute coronary syndrome. In 1999, Janand-Delenne et al observed that every fifth patient with diabetes had a critical stenosis, as evidenced by an angiography of the coronary arteries. This was despite a negative history of stenocardial pain or other features of the ischemic disease [1]. Significant progress in the treatment of diabetes has been made, which has resulted in a reduction in the incidence of micro- and macroangiopathic complications [2,3]. This study aimed to verify epidemiological data from several years and to analyze risk factors, based on clinical and laboratory data, which increased the risk of coronary heart disease
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