Journal
DIABETOLOGIA
Volume 44, Issue 2, Pages 259-266Publisher
SPRINGER
DOI: 10.1007/s001250051609
Keywords
atherosclerosis; autonomic nervous function; coronary artery disease; diabetes mellitus; exercise testing; heart rate; myocardial infarction; myocardial ischaemia; neuropathy; pain perception
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Asymptomatic coronary artery disease and myocardial infarctions are common in diabetic subjects. The available clinical and epidemiological data suggest that the increased incidence of asymptomatic myocardial infarctions and coronary artery disease in diabetic patients mainly reflects accelerated coronary atherosclerosis and the proportion of silent disease relative to symptomatic disease or episodes is not increased in diabetes. In spite of the theoretical background, there is no convincing clinical or epidemiological evidence that diabetic autonomic neuropathy plays a major part in the lack of ischaemic pain. This is not surprising because the mechanisms of silent myocardial ischaemia are complex and controversial even without diabetes.
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