Prognosis for Coronary Stenoses in Patients With Diabetes and Silent Myocardial Ischemia
- Emmanuel Cosson, MD1,
- Michel Guimfack, MD1,
- Jacques Paries, MD1,
- Frédéric Paycha, MD2,
- Jean-Raymond Attali, MD1 and
- Paul Valensi, MD1
- 1Department of Endocrinology-Diabetology-Nutrition, Paris-Nord University, Jean Verdier Hospital, Bondy, France
- 2Department of Nuclear Medicine, Louis Mourier Hospital, Colombes, France
Silent myocardial ischemia (SMI) is common in patients with diabetes (1–4). The prognostic value of SMI, evidenced by exercise electrocardiogram (ECG) stress test (5) and thallium 201 myocardial scintigraphy (6), as well as their association (7) in asymptomatic diabetic patients, has recently been demonstrated. About 50% of the patients with SMI exhibit angiographically normal coronary arteries (1,2). In these patients, endothelial dysfunction and abnormalities of coronary microcirculation may be involved (8). So far, the respective roles played by these functional disorders, by the demonstrated silent coronary stenoses, or by both in the poor prognosis of SMI are still unknown.
The aim of this …
