Coronary Angiography in Diabetic Patients Key Findings from a Senegalese Study

Diabetes is a significant risk factor for coronary artery disease (CAD), accounting for nearly 75% of diabetic-related mortality. Coronary angiography (CAG) plays a crucial role in detecting diffuse and multi-truncal coronary lesions, which often remain silent until severe complications arise. A recent study conducted at the Aristide Le Dantec Teaching Hospital in Dakar, Senegal, highlights the prevalence, indications, and outcomes of CAG in diabetic patients.

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Understanding Coronary Risk in Diabetics

This cross-sectional study analyzed 45 diabetic patients who underwent coronary angiography from May 2013 to July 2015. The findings revealed:

• Hospital prevalence of diabetes in CAG patients: 11.25%
• Average patient age: 62.27 years
• Common cardiovascular risk factors:
  • Hypertension (66.7%)
  • Dyslipidemia (49.6%)
• Primary indications for CAG:
  • Recent myocardial infarction (37.8%)
  • Unstable angina (15.5%)
  • Positive ischemia test (8.9%)

Read the full study at https://doi.org/10.29328/journal.jccm.1001007.

The Reality of Coronary Lesions in Diabetics

The study found that 82.2% of diabetic patients had abnormal coronary angiography results, with:

• 66.6% presenting significant stenosis
• 31.1% having mono-truncal lesions
• 17.8% having bi-truncal lesions
• 17.8% having tri-truncal lesions

The left anterior descending artery (LAD) and right coronary artery (RCA) were the most commonly affected.

Management and Outcomes

Among the 45 patients studied:

• 31.1% underwent percutaneous coronary intervention (PCI) with drug-eluting stents
• 20% required coronary artery bypass grafting (CABG)
• 17.8% were managed with medical therapy alone

The study also noted a complication rate of 8.9%, including radial artery spasms, vagal discomfort, and iatrogenic dissections.

The Importance of Early Detection and Screening

Despite the high prevalence of asymptomatic CAD in diabetics, routine screening for silent myocardial ischemia is often overlooked. The American Diabetes Association (ADA) recommends early cardiovascular risk assessment in diabetic patients to improve outcomes (ADA).

Real-World Implications

This study underscores the urgent need for better cardiovascular screening in diabetic populations, particularly in sub-Saharan Africa. Key takeaways include:

Routine CAG screening for high-risk diabetic patients
Early intervention with PCI or CABG to prevent complications
Improved access to coronary revascularization techniques

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