Prevalence of silent myocardial ischemia in persons with diabetes mellitus or impaired glucose tolerance and association of hemoglobin A1c with prevalence of silent myocardial ischemia.

Silent myocardial ischemia detected by exercise treadmill or pharmacologic sestamibi stress testing was present in 67 of 196 patients (34%) who had diabetes mellitus or impaired glucose tolerance and in 89 of 640 patients (14%) who had normal glucose tolerance (p <0.001). Among those who had diabetes mellitus or impaired glucose tolerance, silent myocardial ischemia was present in 27 of 54 patients (50%) who had a hemoglobin A1c level > or =7.6% and in 39 of 137 patients (28%) with a hemoglobin A1c level <7.6% (p <0.005).