Comment on Elliott et al. Prevalence and Prognosis of Unrecognized Myocardial Infarction in Asymptomatic Patients With Diabetes: A Two-Center Study With Up to 5 Years of Follow-up. Diabetes Care 2019;42:1290–1296

In a recently published article, Elliott et al. (1) determined the prevalence and prognostic significance of unrecognized myocardial infarction (MI) by delayed-enhancement MRI in asymptomatic patients with diabetes without known cardiac disease. Data from the cohort were collected under rigid methodological conditions with very low loss to follow-up and appropriate statistical data analysis. The authors concluded that unnoticeable MI is prevalent in asymptomatic patients with diabetes and confers a markedly increased risk of death and clinical MI, providing significant incremental prognostic value over traditional variables. These data are welcome given the need for improvements in risk prediction models for patients …