A 2005 study examined whether the presence of anginal symptoms can predict abnormal myocardial perfusion or function in diabetic patients. Researchers performed a retrospective review of 1074 patients who underwent myocardial perfusion imaging. Among non-diabetics, anginal symptoms significantly correlated with markers of ischemia like summed stress score and myocardial dysfunction like reduced ejection fraction. However, in diabetic patients, the presence of chest pain did not correlate with any of these markers. Regardless of symptoms, diabetics as a group had higher rates of myocardial ischemia. So relying solely on symptoms to determine which diabetics warrant workup for coronary artery disease seems unreliable.
Citation: Heston, Thomas F. (2005). Anginal symptoms are not predictive of myocardial perfusion in diabetics. Journal of Nuclear Cardiology, 12(4), S108. https://doi.org/10.1016/j.nuclcard.2005.06.028
