High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus

T. Inoguchi, T. Yamashita, F. Umeda, H. Mihara, O. Nakagaki, K. Takada, T. Kawano, H. Murao, T. Doi, H. Nawata

    Research output: Contribution to journalArticle

    63 Citations (Scopus)

    Abstract

    The present study was designed to reveal the incidence of silent myocardial ischemia in asymptomatic elderly non-insulin-dependent diabetic (NIDDM) patients (aged over 60 years). As a first step screening, maximal treadmill exercise test was performed. Of 140 patients studied, 54 (38.6%) were unable or not expected to achieve diagnostic levels of exercise during treadmill testing. A positive exercise test was noted in 39 of 86 (45.3%) subjects. As a second step examination, dipyridamole thallium scintigraphy was performed for 93 subjects who exhibited a positive exercise test and could not perform a maximal exercise test. Abnormal perfusion pattern was found in 39 of 93 (41.9%), who were finally considered to have a silent myocardial ischemia. Coronary angiography was performed in 18 subjects with diagnosis of silent myocardial ischemia, who gave their consent. Significant coronary artery stenosis was in fact found in 17 of 18 (94.4%) subjects studied, confirming a very high positive predictive value of this diagnostic procedure. In conclusion, elderly NIDDM patients (aged over 60 years) had an extremely high prevalence (estimated 26.3%) of silent myocardial ischemia. This evidence suggests that early and intensive detection may be needed as a part of routine care for this group.

    Original languageEnglish
    Pages (from-to)37-44
    Number of pages8
    JournalDiabetes Research and Clinical Practice
    Volume47
    Issue number1
    DOIs
    Publication statusPublished - Jan 1 2000

    Fingerprint

    Exercise Test
    Type 2 Diabetes Mellitus
    Myocardial Ischemia
    Incidence
    Dipyridamole
    Thallium
    Coronary Stenosis
    Coronary Angiography
    Radionuclide Imaging
    Perfusion
    Exercise

    All Science Journal Classification (ASJC) codes

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Endocrinology

    Cite this

    High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus. / Inoguchi, T.; Yamashita, T.; Umeda, F.; Mihara, H.; Nakagaki, O.; Takada, K.; Kawano, T.; Murao, H.; Doi, T.; Nawata, H.

    In: Diabetes Research and Clinical Practice, Vol. 47, No. 1, 01.01.2000, p. 37-44.

    Research output: Contribution to journalArticle

    Inoguchi, T, Yamashita, T, Umeda, F, Mihara, H, Nakagaki, O, Takada, K, Kawano, T, Murao, H, Doi, T & Nawata, H 2000, 'High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus', Diabetes Research and Clinical Practice, vol. 47, no. 1, pp. 37-44. https://doi.org/10.1016/S0168-8227(99)00102-3
    Inoguchi, T. ; Yamashita, T. ; Umeda, F. ; Mihara, H. ; Nakagaki, O. ; Takada, K. ; Kawano, T. ; Murao, H. ; Doi, T. ; Nawata, H. / High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus. In: Diabetes Research and Clinical Practice. 2000 ; Vol. 47, No. 1. pp. 37-44.
    @article{e5abe303be0045679c7a1a015656cf30,
    title = "High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus",
    abstract = "The present study was designed to reveal the incidence of silent myocardial ischemia in asymptomatic elderly non-insulin-dependent diabetic (NIDDM) patients (aged over 60 years). As a first step screening, maximal treadmill exercise test was performed. Of 140 patients studied, 54 (38.6{\%}) were unable or not expected to achieve diagnostic levels of exercise during treadmill testing. A positive exercise test was noted in 39 of 86 (45.3{\%}) subjects. As a second step examination, dipyridamole thallium scintigraphy was performed for 93 subjects who exhibited a positive exercise test and could not perform a maximal exercise test. Abnormal perfusion pattern was found in 39 of 93 (41.9{\%}), who were finally considered to have a silent myocardial ischemia. Coronary angiography was performed in 18 subjects with diagnosis of silent myocardial ischemia, who gave their consent. Significant coronary artery stenosis was in fact found in 17 of 18 (94.4{\%}) subjects studied, confirming a very high positive predictive value of this diagnostic procedure. In conclusion, elderly NIDDM patients (aged over 60 years) had an extremely high prevalence (estimated 26.3{\%}) of silent myocardial ischemia. This evidence suggests that early and intensive detection may be needed as a part of routine care for this group.",
    author = "T. Inoguchi and T. Yamashita and F. Umeda and H. Mihara and O. Nakagaki and K. Takada and T. Kawano and H. Murao and T. Doi and H. Nawata",
    year = "2000",
    month = "1",
    day = "1",
    doi = "10.1016/S0168-8227(99)00102-3",
    language = "English",
    volume = "47",
    pages = "37--44",
    journal = "Diabetes Research and Clinical Practice",
    issn = "0168-8227",
    publisher = "Elsevier Ireland Ltd",
    number = "1",

    }

    TY - JOUR

    T1 - High incidence of silent myocardial ischemia in elderly patients with non insulin-dependent diabetes mellitus

    AU - Inoguchi, T.

    AU - Yamashita, T.

    AU - Umeda, F.

    AU - Mihara, H.

    AU - Nakagaki, O.

    AU - Takada, K.

    AU - Kawano, T.

    AU - Murao, H.

    AU - Doi, T.

    AU - Nawata, H.

    PY - 2000/1/1

    Y1 - 2000/1/1

    N2 - The present study was designed to reveal the incidence of silent myocardial ischemia in asymptomatic elderly non-insulin-dependent diabetic (NIDDM) patients (aged over 60 years). As a first step screening, maximal treadmill exercise test was performed. Of 140 patients studied, 54 (38.6%) were unable or not expected to achieve diagnostic levels of exercise during treadmill testing. A positive exercise test was noted in 39 of 86 (45.3%) subjects. As a second step examination, dipyridamole thallium scintigraphy was performed for 93 subjects who exhibited a positive exercise test and could not perform a maximal exercise test. Abnormal perfusion pattern was found in 39 of 93 (41.9%), who were finally considered to have a silent myocardial ischemia. Coronary angiography was performed in 18 subjects with diagnosis of silent myocardial ischemia, who gave their consent. Significant coronary artery stenosis was in fact found in 17 of 18 (94.4%) subjects studied, confirming a very high positive predictive value of this diagnostic procedure. In conclusion, elderly NIDDM patients (aged over 60 years) had an extremely high prevalence (estimated 26.3%) of silent myocardial ischemia. This evidence suggests that early and intensive detection may be needed as a part of routine care for this group.

    AB - The present study was designed to reveal the incidence of silent myocardial ischemia in asymptomatic elderly non-insulin-dependent diabetic (NIDDM) patients (aged over 60 years). As a first step screening, maximal treadmill exercise test was performed. Of 140 patients studied, 54 (38.6%) were unable or not expected to achieve diagnostic levels of exercise during treadmill testing. A positive exercise test was noted in 39 of 86 (45.3%) subjects. As a second step examination, dipyridamole thallium scintigraphy was performed for 93 subjects who exhibited a positive exercise test and could not perform a maximal exercise test. Abnormal perfusion pattern was found in 39 of 93 (41.9%), who were finally considered to have a silent myocardial ischemia. Coronary angiography was performed in 18 subjects with diagnosis of silent myocardial ischemia, who gave their consent. Significant coronary artery stenosis was in fact found in 17 of 18 (94.4%) subjects studied, confirming a very high positive predictive value of this diagnostic procedure. In conclusion, elderly NIDDM patients (aged over 60 years) had an extremely high prevalence (estimated 26.3%) of silent myocardial ischemia. This evidence suggests that early and intensive detection may be needed as a part of routine care for this group.

    UR - http://www.scopus.com/inward/record.url?scp=0033990228&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=0033990228&partnerID=8YFLogxK

    U2 - 10.1016/S0168-8227(99)00102-3

    DO - 10.1016/S0168-8227(99)00102-3

    M3 - Article

    C2 - 10660219

    AN - SCOPUS:0033990228

    VL - 47

    SP - 37

    EP - 44

    JO - Diabetes Research and Clinical Practice

    JF - Diabetes Research and Clinical Practice

    SN - 0168-8227

    IS - 1

    ER -