Frequency of Silent Myocardial Ischemia in Type 2 Diabetic Patients Having Cardiovascular Autonomic Neuropathy

Abstract

Introduction: Early detection of silent myocardial ischemia plays an important role in prevention of sudden cardiac death and acute myocardial infarction. The studies regarding the frequency of silent myocardial ischemia in diabetic patients having cardiovascular autonomic neuropathy are few so we planned this study to determine the frequency of silent myocardial ischemia among patients with diabetic cardiovascular autonomic neuropathy in our population. Objectives: To determine the frequency of silent myocardial ischemia in type 2 diabetic patients having cardiovascular autonomic neuropathy. Study Design: Cross-Sectional study. Place and Duration of Study: Medical Departments of Allied Hospital and Aziz Fatimah Hospital Faisalabad from 01-08-2013 to 31-01-2014. Methods: This study included 91 type 2 diabetic patients with cardiovascular autonomic neuropathy. All the patients had ECG done. Those who had normal ECG underwent ETT, to determine if there was any silent myocardial ischemia which was described as frequency distribution table. The data was collected on specially designed performa. Results: Total 91 patients were included in the study. Silent myocardial ischemia was present among 35 (38.5%) patients while 56 (61.5%) did not have silent myocardial ischemia. The mean age of the patients was 52.99 + 7.00 years [range 41-71years]. 57 (62.6%) patients were male and 34 (37.4 %) patients were female. ECG was positive for ischemia among 25 (27.5%) patients and ETT was positive for ischemia among 10 (11%) patients. Conclusion: The frequency of the silent myocardial ischemia is high among patients with diabetic cardiovascular autonomic neuropathy, so every diabetic patient with cardiovascular autonomic neuropathy should be screened for ischemic heart disease.