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Prevalence and clinical predictors of silent myocardial ischemia in asymptomatic type 2 Diabetes Mellitus patients at Puducherry, India

Background: Silent MI is common among diabetics due to autonomic dysfunction and loss of pain alert mechanism. There are various risk factors associated with silent MI in diabetes which needs screening earlier to prevent unanticipated cardiovascular mortality. The objective of the present investigation was to study the prevalence and clinical factors associated with silent myocardial ischemia as diagnosed by TMT among type 2 diabetics who had no previous history or symptoms of cardio-vascular disease.Methods: A total of 200 type 2 diabetes affected subjects with duration of diabetes for at least 6 months, above 18 years of age, attending to the diabetology OPD, during the time period June 2017 to May 2018 were included in the study. Blood investigations and TMT were done for all the participants and documented in a proforma.Results: Silent MI was documented by using TMT in 36.5% (n=73) of patients with type 2 diabetes mellitus. The factors like age (59.1±16.3 years), duration of diabetes (8.2±2.6 years), obesity (BMI=29.6±4.7 kg/m2), Glycated haemoglobin (9.7±2.8 %), lipid levels and post-prandial blood sugar levels (236±11.8 mg/dl) associated well with silent MI as predicted by TMT. Fasting blood sugar did not show significant association with Silent MI.Conclusions: The prevalence of silent MI was higher among the type 2 diabetic individuals compared to non-diabetics. Age, duration of diabetes, HbA1c levels, BMI, dyslipidemia and post prandial blood glucose levels were associated significantly with incidence of silent MI in patients with type 2 diabetes.