Silent myocardial ischemia in diabetic patients (type 2)‎ with microalbuminuria

Abstract EN

Objective : 7b study the microalbuminuria as a risk factor for development of silent myocardial ischemia in non-insulin dependent diabetes mellitus patients(type 2).

Methods : This study included 50 diabetic patients ( type 2), 22 males and 28 females.

They were divided into two groups ; Group 1: 25 patients with microalbuminuria, Group 2 : 25 patients without microalbuminuria.

All patients were subjected to clinical examination estimation of fasting and postprandial blood sugar,serum creatinine, serum cholesterol, triglycerides, HDL and LDL.

Detection of microalbuminuria by RIA based on 3 hours over night samples.

Ambulatory electrocardiogram monitoring for 24 hours as well as treadmill stress electrocardiogram were performed for detection of ST segment depression for diagnosis of silent myocardial ischemia.

Transthoracic echocardiography was done for detection of regional wall motion abnormalities ,systolic or diastolic dysfunction.

Results : It was observed that the prevalence of silent ischemia in diabetic patients with microalbuminuria is higher (40%) with statistical significance than those with albumin free urine(12%) P=0.02 .Many risk factors (hypertension, smoking,dyslipidemia and male sex ) were more prevalent in the presence of microalbuminuria .However ,it did not reach a statistical significance.So,they were not direct independent effectors-unlike microalbuminuria-for the development of silent myocardial ischemia in diabetic patients(type 2).

Conclusion: Silent myocardial ischemia is common in asymptomatic non insulin dependent diabetes mellitus patients with microalbuminuria .The study recommend routine screening for silent myocardial ischemia in this group of patients especially if they have other risk factors for CAD (smoking, hypertension, dyslipidemia).