Rathi Lakhveer, Habib Taha Hassan, Rasool Mohammad Ibrahim, Ifunanya Orji Victor, Khalid Jamil Javeria Binte, Khan Sheheryar, Bin Nasir Muhammad Usama Saud, Latif Aqib, Ghaffar Fazal, Raza Hafiz Ali
Rheumatology, University Hospital Limerick, Limerick, IRL.
Medicine, Niazi Medical and Dental College, Sargodha, PAK.
Cureus. 2025 Aug 10;17(8):e89722. doi: 10.7759/cureus.89722. eCollection 2025 Aug.
Silent myocardial ischemia (SMI) is a common but frequently overlooked manifestation of coronary artery disease in patients with diabetes mellitus, largely due to autonomic neuropathy and atypical symptom presentation.
To determine the frequency of SMI in diabetic patients presenting with non-cardiac complaints using electrocardiography (ECG), serum troponin-I, and non-invasive stress testing, and to assess its association with clinical risk factors.
This cross-sectional observational study was conducted at Niazi Medical and Dental College, Niazi Welfare Foundation Teaching Hospital, from June 2023 to June 2024. A total of 255 diabetic patients were enrolled through consecutive non-probability sampling. Data were collected on demographics, duration of diabetes, associated comorbid conditions (e.g., hypertension, dyslipidemia), and current medications. Investigations included a resting 12-lead ECG, random blood glucose, serum troponin-I, HbA1c, and lipid profile.
The mean age of participants was 56.8 ± 10.9 years, and 56.5% were male. Ischemic changes on ECG were noted in 43 patients (16.9%), and 12 patients (4.7%) had elevated troponin-I levels. Stress testing was performed in 55 patients, confirming SMI in 39 (15.3%). SMI was significantly associated with a duration of diabetes >10 years (p = 0.02), HbA1c >8% (p < 0.01), and hypertension (p = 0.04). No significant association was found with age (p = 0.09) or gender (p = 0.19).
SMI is prevalent in diabetic patients presenting with non-cardiac complaints, with poor glycemic control and long-standing diabetes being strong predictors. Routine cardiac screening should be considered in high-risk asymptomatic diabetics to enable early detection and timely intervention.
无症状性心肌缺血（SMI）是糖尿病患者冠状动脉疾病常见但常被忽视的表现，主要归因于自主神经病变和非典型症状表现。
使用心电图（ECG）、血清肌钙蛋白I和无创性负荷试验确定出现非心脏症状的糖尿病患者中SMI的发生率，并评估其与临床危险因素的关联。
本横断面观察性研究于2023年6月至2024年6月在尼亚齐医学与牙科学院、尼亚齐福利基金会教学医院进行。通过连续非概率抽样纳入了255例糖尿病患者。收集了人口统计学、糖尿病病程、相关合并症（如高血压、血脂异常）及当前用药的数据。检查包括静息12导联心电图、随机血糖、血清肌钙蛋白I、糖化血红蛋白（HbA1c）和血脂谱。
参与者的平均年龄为56.8±10.9岁，56.5%为男性。43例患者（16.9%）心电图出现缺血性改变，12例患者（4.7%）肌钙蛋白I水平升高。55例患者进行了负荷试验，其中39例（15.3%）确诊为SMI。SMI与糖尿病病程>10年（p = 0.02）、HbA1c>8%（p < 0.01）和高血压（p = 0.04）显著相关。未发现与年龄（p = 0.09）或性别（p = 0.19）有显著关联。
在出现非心脏症状的糖尿病患者中SMI很常见，血糖控制不佳和糖尿病病程长是其强有力的预测因素。对于高危无症状糖尿病患者应考虑进行常规心脏筛查，以便早期发现并及时干预。
