The epidemic of diabetes continues to grow, with recent prevalence estimates of 12% among U.S. adults. Though type 2 diabetes is associated with a two- to fourfold heightened risk of cardiovascular disease, this risk is heterogeneously distributed (1). Thus, markers of cardiovascular risk beyond traditional risk factors are needed. Prior efforts to incorporate novel blood biomarkers in risk prediction have found only modest additive value in risk discrimination, despite significant economic cost (2,3). The routine 12-lead electrocardiogram (ECG) may represent a cost-effective measure to refine atherosclerotic cardiovascular disease (ASCVD) risk. Silent myocardial infarction (SMI) is more common among those with diabetes due to impaired nociception. The risk of ASCVD among those with prior SMI and diabetes has not been adequately studied.

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沉默性心肌梗死与糖尿病主要心血管事件的关联：ACCORD试验

糖尿病的流行持续增长，最近在美国成年人中患病率估计为12％。尽管2型糖尿病的患心血管疾病的风险增加了2到4倍，但这种风险的分布却不均一（1）。因此，需要超越传统危险因素的心血管危险指标。尽管在经济上付出了巨大的代价，但在将新的血液生物标记物纳入风险预测的先前努力中，在风险识别中仅发现了适度的附加价值（2,3）。常规的12导联心电图（ECG）可能是一种经济有效的措施，可以改善动脉粥样硬化性心血管疾病（ASCVD）的风险。沉默的心肌梗塞（SMI）在糖尿病患者中由于伤害感受受损而更为常见。先前患有SMI和糖尿病的人中ASCVD的风险尚未得到充分研究。