Angina and Exertional Myocardial Ischemia in Diabetic and Nondiabetic Patients: Assessment by Exercise Thallium Scintigraphy
Abstract
Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 14 [corrected] patients with diabetes compared with 34 [corrected] patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.
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The absolute risk of CAD among Japanese diabetic patients is thought to be 30-70% compared with that of diabetic Europeans and Americans.
“Although the absolute risk of CAD among Japanese diabetic patients is thought to be 30–70% compared to that of diabetic Europeans and Americans130, 131)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [131]
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Self-citation
- Authors
- NESTO, R. W., PHILLIPS, R. T., KETT, K. G., HILL, T., PERPER, E., YOUNG, E., & LELAND, O. S.
- Affiliations
- Boston, Massachusetts
- Corresponding author
- NESTO, RICHARD W.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1988-02-01
- Volume
- 108
- Issue
- 2
- Pages
- 170-175
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2046901106
- Cited by
- 247
- References
- 31
- Citations by year
- 2026: 1 · 2023: 2 · 2022: 2 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 2 · 2015: 8 · 2014: 9 · 2013: 10 · 2012: 4
- FWCI
- 10.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- angina pectoris, myocardial ischemia, diabetes mellitus, coronary artery disease, exercise thallium scintigraphy, silent myocardial ischemia, diabetes complications, retinopathy, kidney disease, peripheral neuropathy
- MeSH terms
- Adult, Aged, Angina Pectoris, Coronary Circulation, Coronary Disease, Electrocardiography, Exercise Test, Physical Exertion, Female, Heart, Humans, Male, Middle Aged, Radionuclide Imaging, Thallium Radioisotopes, Diabetes Complications
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