, Volume 44, Issue 2, pp 259–266

Silent coronary artery disease in diabetes – a feature of autonomic neuropathy or accelerated atherosclerosis?

  • K. E. J. Airaksinen
For debate


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. [Diabetologia (2001) 44: 259–266]

Keywords Atherosclerosis autonomic nervous function coronary artery disease diabetes mellitus exercise testing heart rate myocardial infarction myocardial ischaemia neuropathy pain perception. 

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • K. E. J. Airaksinen
    • 1
  1. 1.Department of Medicine, University of Turku, FinlandFI

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