Silent myocardial ischemia in asymptomatic patients with type 2 diabetes mellitus without previous histories of cardiovascular disease

Yuki Kawano, Masao Takemoto, Takahiro Mito, Hiroko Morisaki, Atsushi Tanaka, Yuka Sakaki, Atsutoshi Matsuo, Kentaro Abe, Satoru Hida, Kumiko Mukae, Teiji Okazaki, Kei Ichiro Tayama, Toyoshi Inoguchi, Kiyonobu Yoshitake, Ken Ichi Kosuga

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Background: The number of patients with type 2 diabetes mellitus (T2DM) continues to increase all over the world. Cardiovascular disease (CVD), especially coronary artery disease (CAD), is a major cause of the morbidity and mortality in patients with T2DM. The prognosis of patients with silent myocardial ischemia (SMI) is worse than that in those without. Methods and results: Thus, to assess how many patients with SMI existed among those patients, CVD screening tests were performed in 128 asymptomatic patients with T2DM without previous histories of CVD. SMI could be detected in 24 patients (19%) by exercise stress tests and/or the coronary fractional flow reserve. Their 12-lead electrocardiogram and cardiac ultrasonography were both normal. Compared to those without SMI, those with had a statistically significant longer history of T2DM (17 ± 1 versus 11 ± 1 years, p = 0.006), and the co-existence of a family history of CVD (42% versus 21%, p = 0.037). Furthermore, these factors were demonstrated as independent risk factors of SMI by a multivariate analysis (Odds ratio 1.060 and 4.000, respectively), and in accordance with the disease duration of T2DM, the prevalence of patients with SMI has been increasing (p = 0.019). Conclusions: Physicians should be aware of these conditions when examining patients with T2DM, especially with a family history of CVD and/or long disease duration (> 11 years) of T2DM, even though they have no symptoms, previous histories of CVDs, and/or abnormal findings on the 12-lead electrocardiogram and cardiac ultrasonography. This may be an effective, safe, and attractive diagnostic strategy for those asymptomatic patients with T2DM.

    Original languageEnglish
    Pages (from-to)151-155
    Number of pages5
    JournalInternational Journal of Cardiology
    Volume216
    DOIs
    Publication statusPublished - Aug 1 2016

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    Type 2 Diabetes Mellitus
    Myocardial Ischemia
    Cardiovascular Diseases
    Exercise Test
    Ultrasonography
    Electrocardiography
    Coronary Artery Disease
    Multivariate Analysis
    Odds Ratio
    Morbidity
    Physicians
    Mortality

    All Science Journal Classification (ASJC) codes

    • Cardiology and Cardiovascular Medicine

    Cite this

    Silent myocardial ischemia in asymptomatic patients with type 2 diabetes mellitus without previous histories of cardiovascular disease. / Kawano, Yuki; Takemoto, Masao; Mito, Takahiro; Morisaki, Hiroko; Tanaka, Atsushi; Sakaki, Yuka; Matsuo, Atsutoshi; Abe, Kentaro; Hida, Satoru; Mukae, Kumiko; Okazaki, Teiji; Tayama, Kei Ichiro; Inoguchi, Toyoshi; Yoshitake, Kiyonobu; Kosuga, Ken Ichi.

    In: International Journal of Cardiology, Vol. 216, 01.08.2016, p. 151-155.

    Research output: Contribution to journalArticle

    Kawano, Y, Takemoto, M, Mito, T, Morisaki, H, Tanaka, A, Sakaki, Y, Matsuo, A, Abe, K, Hida, S, Mukae, K, Okazaki, T, Tayama, KI, Inoguchi, T, Yoshitake, K & Kosuga, KI 2016, 'Silent myocardial ischemia in asymptomatic patients with type 2 diabetes mellitus without previous histories of cardiovascular disease', International Journal of Cardiology, vol. 216, pp. 151-155. https://doi.org/10.1016/j.ijcard.2016.04.008
    Kawano, Yuki ; Takemoto, Masao ; Mito, Takahiro ; Morisaki, Hiroko ; Tanaka, Atsushi ; Sakaki, Yuka ; Matsuo, Atsutoshi ; Abe, Kentaro ; Hida, Satoru ; Mukae, Kumiko ; Okazaki, Teiji ; Tayama, Kei Ichiro ; Inoguchi, Toyoshi ; Yoshitake, Kiyonobu ; Kosuga, Ken Ichi. / Silent myocardial ischemia in asymptomatic patients with type 2 diabetes mellitus without previous histories of cardiovascular disease. In: International Journal of Cardiology. 2016 ; Vol. 216. pp. 151-155.
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    abstract = "Background: The number of patients with type 2 diabetes mellitus (T2DM) continues to increase all over the world. Cardiovascular disease (CVD), especially coronary artery disease (CAD), is a major cause of the morbidity and mortality in patients with T2DM. The prognosis of patients with silent myocardial ischemia (SMI) is worse than that in those without. Methods and results: Thus, to assess how many patients with SMI existed among those patients, CVD screening tests were performed in 128 asymptomatic patients with T2DM without previous histories of CVD. SMI could be detected in 24 patients (19{\%}) by exercise stress tests and/or the coronary fractional flow reserve. Their 12-lead electrocardiogram and cardiac ultrasonography were both normal. Compared to those without SMI, those with had a statistically significant longer history of T2DM (17 ± 1 versus 11 ± 1 years, p = 0.006), and the co-existence of a family history of CVD (42{\%} versus 21{\%}, p = 0.037). Furthermore, these factors were demonstrated as independent risk factors of SMI by a multivariate analysis (Odds ratio 1.060 and 4.000, respectively), and in accordance with the disease duration of T2DM, the prevalence of patients with SMI has been increasing (p = 0.019). Conclusions: Physicians should be aware of these conditions when examining patients with T2DM, especially with a family history of CVD and/or long disease duration (> 11 years) of T2DM, even though they have no symptoms, previous histories of CVDs, and/or abnormal findings on the 12-lead electrocardiogram and cardiac ultrasonography. This may be an effective, safe, and attractive diagnostic strategy for those asymptomatic patients with T2DM.",
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    AU - Kawano, Yuki

    AU - Takemoto, Masao

    AU - Mito, Takahiro

    AU - Morisaki, Hiroko

    AU - Tanaka, Atsushi

    AU - Sakaki, Yuka

    AU - Matsuo, Atsutoshi

    AU - Abe, Kentaro

    AU - Hida, Satoru

    AU - Mukae, Kumiko

    AU - Okazaki, Teiji

    AU - Tayama, Kei Ichiro

    AU - Inoguchi, Toyoshi

    AU - Yoshitake, Kiyonobu

    AU - Kosuga, Ken Ichi

    PY - 2016/8/1

    Y1 - 2016/8/1

    N2 - Background: The number of patients with type 2 diabetes mellitus (T2DM) continues to increase all over the world. Cardiovascular disease (CVD), especially coronary artery disease (CAD), is a major cause of the morbidity and mortality in patients with T2DM. The prognosis of patients with silent myocardial ischemia (SMI) is worse than that in those without. Methods and results: Thus, to assess how many patients with SMI existed among those patients, CVD screening tests were performed in 128 asymptomatic patients with T2DM without previous histories of CVD. SMI could be detected in 24 patients (19%) by exercise stress tests and/or the coronary fractional flow reserve. Their 12-lead electrocardiogram and cardiac ultrasonography were both normal. Compared to those without SMI, those with had a statistically significant longer history of T2DM (17 ± 1 versus 11 ± 1 years, p = 0.006), and the co-existence of a family history of CVD (42% versus 21%, p = 0.037). Furthermore, these factors were demonstrated as independent risk factors of SMI by a multivariate analysis (Odds ratio 1.060 and 4.000, respectively), and in accordance with the disease duration of T2DM, the prevalence of patients with SMI has been increasing (p = 0.019). Conclusions: Physicians should be aware of these conditions when examining patients with T2DM, especially with a family history of CVD and/or long disease duration (> 11 years) of T2DM, even though they have no symptoms, previous histories of CVDs, and/or abnormal findings on the 12-lead electrocardiogram and cardiac ultrasonography. This may be an effective, safe, and attractive diagnostic strategy for those asymptomatic patients with T2DM.

    AB - Background: The number of patients with type 2 diabetes mellitus (T2DM) continues to increase all over the world. Cardiovascular disease (CVD), especially coronary artery disease (CAD), is a major cause of the morbidity and mortality in patients with T2DM. The prognosis of patients with silent myocardial ischemia (SMI) is worse than that in those without. Methods and results: Thus, to assess how many patients with SMI existed among those patients, CVD screening tests were performed in 128 asymptomatic patients with T2DM without previous histories of CVD. SMI could be detected in 24 patients (19%) by exercise stress tests and/or the coronary fractional flow reserve. Their 12-lead electrocardiogram and cardiac ultrasonography were both normal. Compared to those without SMI, those with had a statistically significant longer history of T2DM (17 ± 1 versus 11 ± 1 years, p = 0.006), and the co-existence of a family history of CVD (42% versus 21%, p = 0.037). Furthermore, these factors were demonstrated as independent risk factors of SMI by a multivariate analysis (Odds ratio 1.060 and 4.000, respectively), and in accordance with the disease duration of T2DM, the prevalence of patients with SMI has been increasing (p = 0.019). Conclusions: Physicians should be aware of these conditions when examining patients with T2DM, especially with a family history of CVD and/or long disease duration (> 11 years) of T2DM, even though they have no symptoms, previous histories of CVDs, and/or abnormal findings on the 12-lead electrocardiogram and cardiac ultrasonography. This may be an effective, safe, and attractive diagnostic strategy for those asymptomatic patients with T2DM.

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