| Predictive value of cardiac autonomic neuropathy in diabetic patients with or without silent myocardial ischemia. | |
| | |
MedLine Citation:
|
PMID: 11213889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The aim of this study was to determine the predictive value of silent myocardial ischemia (SMI) and cardiac autonomic neuropathy (CAN) in asymptomatic diabetic patients. RESEARCH DESIGN AND METHODS: We recruited 120 diabetic patients with no history of myocardial infarction or angina, a normal 12-lead electrocardiogram (ECG), and two or more additional risk factors. SMI assessment was carried out by means of an ECG stress test, a thallium-201 myocardial scintigraphy with dipyridamole, and 48-h ECG monitoring. CAN was searched for by standardized tests evaluating heart rate variations. Accurate follow-up information for 3-7 years (mean 4.5) was obtained in 107 patients. RESULTS: There was evidence of SMI in 33 patients (30.7%). CAN was detected in 33 of the 75 patients (38.9%) who were tested, and a major cardiac event occurred in 11 of them. Among these 75 patients, the proportion of major cardiac events in the SMI+ patients was not significantly higher than that in the SMI- patients (6 of 25 vs. 5 of 50 patients), whereas it was significantly higher in the CAN+ patients than in the CAN- patients (8 of 33 vs. 3 of 42 patients; P = 0.04), with a relative risk of 4.16 (95% CI 1.01-17.19) and was the highest in the patients with both SMI and CAN (5 of 10 patients). After adjusting for SMI, there was a significant association between CAN and major cardiac events (P = 0.04). CONCLUSIONS: In asymptomatic diabetic patients, CAN appears to be a better predictor of major cardiac events than SMI. The risk linked to CAN appears to be independent of SMI and is the highest when CAN is associated with SMI. |
| | |
Authors:
|
P Valensi; R N Sachs; B Harfouche; B Lormeau; J Paries; E Cosson; F Paycha; M Leutenegger; J R Attali |
Related Documents
:
|
22814759 - Levels of salivary iga in patients with minor recurrent aphthous stomatitis: a matched ... 17636329 - Cardiotoxicity of fluoropyrimidines in different schedules of administration: a prospec... 9158709 - Calcified amorphous tumor of the heart (cardiac cat). 8269209 - Coronary artery spasm is a major cause of sudden cardiac arrest in survivors without un... 9352989 - Accuracy of an automatic and patient-triggered long-term solid memory ambulatory cardia... 10211629 - Cardiac troponin elevations in chronic renal failure: prevalence and clinical significa... 7466439 - Primary hyperparathyroidism and the gastrointestinal tract. 16434649 - Virtual reality cues for improvement of gait in patients with multiple sclerosis. 17194949 - Preclinic appointment telephone contact: an effective intervention for colposcopy clini... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Diabetes care Volume: 24 ISSN: 0149-5992 ISO Abbreviation: Diabetes Care Publication Date: 2001 Feb |
Date Detail:
|
Created Date: 2001-02-13 Completed Date: 2001-03-29 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: United States |
Other Details:
|
Languages: eng Pagination: 339-43 Citation Subset: IM |
Affiliation:
|
Department of Endocrinology, Diabetology, and Nutrition, Jean Verdier Hospital, Bondy, France. paul.valensi@jvr.ap-hop-paris.fr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Arteritis / complications, ultrasonography Autonomic Nervous System Diseases / complications, diagnosis* Cardiovascular Diseases / epidemiology, etiology Coronary Angiography Diabetes Complications* Electrocardiography Exercise Test Follow-Up Studies Heart / innervation* Humans Leg Middle Aged Multivariate Analysis Myocardial Infarction / epidemiology, etiology Myocardial Ischemia / complications, diagnosis*, radionuclide imaging Posture Respiration Valsalva Maneuver |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Increased prevalence of significant coronary artery calcification in patients with diabetes.
Next Document: Contribution of nerve-axon reflex-related vasodilation to the total skin vasodilation in diabetic pa...