SILENT ISCHEMIA IN TYPE I DIABETIC PATIENTS: A STUDY OF EKG CHANGES

Abstract  INTRODUCTION: Ischemic Heart Diseases (IHD) is the major cause of mortality and morbidity worldwide. Diabetes Mellitus (DM) is known as one of the main risk factors of IHD. Silent ischemia is seen in diabetic patients more that in others. Identification of these cases is of great value in clinical practice. In this study, ECG changes and their relationship with clinical symptoms of ischemia were evaluated in diabetes type II patients. methods: In a cross-sectional study at Isfahan Endocrinology and Metabolism Research Center on diabetes type II patients (۲۰۰۴), ۵۰۰ consecutive records out of nearly ۵۰۰۰ active records were selected via a simple sampling method. ۱۲-lead resting ECG was taken from all patients. Minnesota codes were used to study ECG changes. Patients with electrocardiograms suggestive of ischemia or MI but no chest pain were considered as having silent ischemia. results: A total of ۵۰۰ subjects (۴۴.۴% men and ۵۵.۶% women) were studied. EKG changes favoring MI, probable MI, and ischemia were seen in ۲%, ۱۲.۴%, and ۱۳.۶% of patients. Silent ischemia had a prevalence of ۸۵.۶%. Of this number, ۶.۳% had suffered definitive MI based on EKG changes. Discussion: Silent ischemia is very common in diabetic patients. Alertness to silent ischemia, especially in the elderly can greatly contribute to early detection of CVD and adoption of timely therapeutic measures in these patients. However, as this study was merely based on resting-state EKG changes, the findings may be questionable. Hence, further studies using more accurate ischemia detection methods are warranted.Keywords .Diabetes Mellitus . Silent Ischemia . Minnesota Code .Cardiovascular Disease