Frequency of painless myocardial ischemia during exercise tolerance testing in patients with and without diabetes mellitus

Stuart R. Chipkin, David Frid, Joseph S Alpert, Stephen P. Baker, James E. Dalen, Neil Aronin

Research output: Contribution to journalArticle

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Abstract

To evaluate the frequency of painless myocardial ischemia, all patients with positive exercise tolerance test responses (at least 2 mm of ST depression) from 1983 to 1985 were examined. Of the 211 patients with exercise-induced ischemia, 101 (48%) did not have pain during the ischemic period; 26 (12%) had diabetes mellitus, 24 of whom (92%) had type II diabetes mellitus. Lack of pain was not correlated with age, gender, history of cigarette smoking, systemic hypertension, past acute myocardial infarction, coronary artery bypass grafting, use of β-blocking or calcium-channel blocking drugs, number of narrowed coronary arteries or average calculated ejection fraction at cardiac catheterization. Patients with painless myocardial ischemia were less often taking nitrates (39% vs 55%, p <0.05) and reported prior episodes of chest pain less often (50% vs 82%, p <0.01) than control subjects. There was no difference in the frequency of painless myocardial ischemia between patients with and without diabetes mellitus (54% vs 47%). Duration of exercise was shorter in patients with diabetes mellitus and in patients who had pain with myocardial ischemia. No significant difference in age, gender, use of nitrates, β-blocking or calcium-channel blocking drugs, history of myocardial infarction, angina pectoris or cigarette smoking was found between diabetic and nondiabetic patients. Systemic hypertension was more common in diabetic patients. Thus, painless myocardial ischemia is common in our patients with positive exercise tolerance test responses, but its frequency is similar in diabetic and nondiabetic patients.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalThe American journal of cardiology
Volume59
Issue number1
DOIs
StatePublished - Jan 1 1987
Externally publishedYes

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Exercise Tolerance
Myocardial Ischemia
Diabetes Mellitus
Calcium Channel Blockers
Exercise Test
Pain
Nitrates
Smoking
Myocardial Infarction
Exercise
Hypertension
Angina Pectoris
Cardiac Catheterization
Chest Pain
Coronary Artery Bypass
Type 2 Diabetes Mellitus
Coronary Vessels
Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Frequency of painless myocardial ischemia during exercise tolerance testing in patients with and without diabetes mellitus. / Chipkin, Stuart R.; Frid, David; Alpert, Joseph S; Baker, Stephen P.; Dalen, James E.; Aronin, Neil.

In: The American journal of cardiology, Vol. 59, No. 1, 01.01.1987, p. 61-65.

Research output: Contribution to journalArticle

Chipkin, Stuart R. ; Frid, David ; Alpert, Joseph S ; Baker, Stephen P. ; Dalen, James E. ; Aronin, Neil. / Frequency of painless myocardial ischemia during exercise tolerance testing in patients with and without diabetes mellitus. In: The American journal of cardiology. 1987 ; Vol. 59, No. 1. pp. 61-65.
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