Abstract

Case Report

Indications and Results of Coronarography in Senegalese Diabetic Patients: About 45 Cases

Ndao SCT*, Gaye ND, Dioum M, Ngaide AA, Mingou JS, Ndiaye MB, Diao M and Ba SA

Published: 20 February, 2017 | Volume 2 - Issue 1 | Pages: 013-019

Introduction: Coronary disease accounts for 75% of diabetic mortality. Coronary angiography reveals lesions that are often diffuse, staggered and multi-truncated. The objective of this study was to determine the indications and results of coronary angiography in diabetic patients.

Method: This is a cross-sectional, descriptive and analytical study which took place from May 2013 to July 2015 at the cardiology clinic of the Aristide Le Dantec hospital. We have included all diabetics who have benefited from coronary angiography by studying clinical and paraclinical data, particularly coronary angiography ones.

Results: During this period, 400 patients had coronary angiography, including 45 diabetics, a hospital prevalence of 11.25%. The average age of our patients was 62.27 y/o with extremes of 44 and 85 y/o. The sex ratio was 1.6 in favor of men. Diabete was revealed in 42 patients. Almost all patients were type II diabetics (44 patients) since 9.94 years in average. The associated cardiovascular risk factors were hypertension 66.7% and dyslipidemia 49.6%. Only 4 patients had typical chest pain. The electrocardiogram was abnormal in 84.4% of cases with 26 cases of SCA ST +. Coronary angiography was abnormal in 37 patients with significant stenosis in 30 patients. A single-truncular lesion was found in 14 cases, 8 had bi-truncular and other 8 had tri-truncular one. The anterior interventricular artery and the segment II of the right coronary were the most affected branches. Concerning the management, 14 patients had angioplasty with an active stent, 8 patients had medical treatment alone and 9 patients had coronary artery bypass surgery. Accidents occured for 4 patients, two of whom had arterial spasm, one of a vagal discomfort and another had an occlusion of the circumflex that led to the implantation of a stent.

Conclusion: Diabetes is accompanied by progressive coronary atherosclerosis, which has an adverse effect on patients' prognosis. Tri-truncal affection and indications for coronary artery bypass surgery are common

Read Full Article HTML DOI: 10.29328/journal.jccm.1001007 Cite this Article Read Full Article PDF

Keywords:

Coronary angiography; Diabetic; Dakar

References

  1. ajio H, Takahashi Y, Kishimoto M, Noto H, et al. Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study. BMJ Open. 2011; 1: 139. Ref.: https://goo.gl/SdqhsE
  2. Charbonnel B, Bouhanick B, Le Feuvre C. Recommendations of SPC/ALFEDIAM on the care of diabetic patient as seen by the cardiologist. Diabetes Metab. 2004; 30: S2-S24. Ref.: https://goo.gl/qo8BxL
  3. Muhlestein JB, Lappé DL, Lima JA, Rosen BD, May HT, et al. Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: the FACTOR-64 randomized clinical trial. JAMA. 2014; 312: 2234-2243. Ref.: https://goo.gl/4zJ4IH
  4. Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, et al. Risk factors for coronary artery diseases in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998; 316: 823-828. Ref.: https://goo.gl/ZFCDpo
  5. Chaâbane A, Rekik N, Graja S, Mnif M, Abid M. Caractéristiques épidémiologiques, cliniques et thérapeutiques de la coronaropathie chez les patients diabétiques au service d’endocrinologie-diabétologie, CHU Hédi Chaker, Sfax, Tunisie. Diabetes Metab. 2013; 39: 72. Ref.: https://goo.gl/aX374N
  6. Armand L, Larifla FL, Velayoudom J, Deloumeaux J, Weladji G, et al. Coronaropathie et diabète dans la population guadeloupéenne. Diabetes Metab. 2012; 38: 40. Ref. https://goo.gl/rvlIwJ
  7. Goraya TY, Leibson CL, Palumbo PJ, Weston SA, Killian JM, et al. Coronary atherosclerosis in diabetes mellitus: a population-based autopsy study. J Am Coll Cardiol. 2002; 40: 946-953. Ref.: https://goo.gl/R1XKVI
  8. Trilla M, Freixa X, Regueiro A, Fernández-Rodriguez D, Brugaletta S, et al. Impact of Aging on Radial Spasm During Coronary Catheterization. J Invasive Cardiol. 2015; 27: 303-307. Ref.: https://goo.gl/dfXWwd
  9. Djenić N, Dzudović B, Romanović R, Ratković N, Jović Z, et al. Iatrogenic dissection of the left main coronary artery during elective diagnostic procedures--A report on three cases. Vojnosanit Pregl. 2016; 73: 284-287. Ref.: https://goo.gl/1JVK1r
  10. Barber-Chamoux N, Souteyrand G, Combaret N, Ouedraogo E, Lusson JR, et al. Contribution of optical coherence tomography imaging in management of iatrogenic coronary dissection. Cardiovasc Revasc Med. 2016; 17: 138-142. Ref.: https://goo.gl/jgGH5O

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