Etude préliminaire sur le diagnostic de l’ischémie myocardique : scintigraphie versus coronarographique chez le diabétique

Abstract

Introduction: Myocardial ischemia is a common complication of diabetes. It is a leading cause of premature death worldwide. Myocardial scintigraphy can detect myocardial ischemia before clinical signs appear. Due to its negative predictive value, scintigraphy can reduce the overuse of coronary angiography, which is an invasive technique.

Methodology: This was a retrospective, descriptive, and analytical study conducted over an 11-month period (December 2018 to October 2019) at the Niamey General Reference Hospital and the Institute of Radioisotopes. All diabetic patients followed up in the endocrinology department of the General Reference Hospital who had undergone myocardial scintigraphy and coronary angiography were included. Data were entered and analyzed using Epi Info software version 7.20.

Results: Myocardial scintigraphy was performed in 15 diabetic patients who had undergone coronary angiography, representing 24.6% of the total.  Males accounted for 53.3% (sex ratio = 1.4) with a mean age of 57.3 ± 8.6 years, ranging from 48 to 74 years. All patients were hypertensive, with 20% having dyslipidemia. The average duration of diabetes was 10.9 ± 7.6 years. Scintigraphy was indicated to investigate silent ischemia in 93.3% of cases. It revealed myocardial ischemia in 73.3% of cases. Coronary angiography revealed single-vessel disease in 26.7% of patients; this consisted of stenosis of the anterior interventricular trunk in 33.3% of cases, stenosis of the circumflex artery in 33.3% of cases, and chronic total occlusion of the right coronary artery in 20% of cases.

Conclusion: Coronary angiography and scintigraphy are necessary for screening for myocardial ischemia in diabetics with a view to possibly proposing revascularization.