Silent coronary artery disease in patients with diabetes mellitus.

Coronary artery disease (CAD) represents the leading cause of death in diabetic patients. Silent myocardial ischaemia more often occurs in diabetics than in non-diabetics. It has been well recognised that silent myocardial ischaemia is not different from symptomatic ischaemia with respect to prognosis and adverse events. Asymptomatic high-risk diabetic patients therefore might benefit from routine screening for silent ischaemia and risk stratification; furthermore, silent ischaemia has to be treated accordingly.