Treatment challenges in a very high-risk diabetic patient with coronary artery disease

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Unstable angina and Type 2 diabetes mellitus (n=1). Intervention: Multifactorial medical therapy and percutaneous coronary intervention.

Dragica Andrić; Milenko Čanković; Anastazija Stojšić-Milosavljević; Dragan Tešić; Stefan Andrić; Milovan Petrović; Jadranka Dejanović; Tatjana Miljković; Milan Nedeljković

doi:10.5937/siks2011027a

January 1, 2020Srce i krvni sudoviOpen Access

Treatment challenges in a very high-risk diabetic patient with coronary artery disease

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Key Points

To describe the therapeutic challenges and multidisciplinary management strategy in a very high-risk patient with type 2 diabetes and complex coronary artery disease presenting with unstable angina.
Evaluated a 58-year-old woman with type 2 diabetes, obesity (BMI 34 kg/m2), hypertension, and dyslipidemia presenting with crescendo angina.
Performed baseline invasive coronary angiography and percutaneous coronary intervention with a drug-eluting stent, followed by medical optimization and repeat angiography at one-year follow-up.
Initial angiography demonstrated a bifurcation lesion of the medial left anterior descending (LAD) artery with 90% stenosis and first diagonal branch (D1) with 99% stenosis and 2 mm vessel diameter, treated with one drug-eluting stent in the medial LAD.
Repeat coronary angiography at one year showed a patent stent in the mid-LAD alongside diffuse distal narrowing (LAD diameter <1.5 mm, D1 diameter ≤2 mm) unsuitable for further intervention, requiring intensified medical therapy including empagliflozin, trimetazidine, and ezetimibe.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 58-year-old woman with type 2 diabetes mellitus, multiple cardiovascular risk factors, and unstable angina who underwent PCI and was followed for 1 year.

I

Intervention

Percutaneous coronary intervention (PCI) with DES followed by optimized medical therapy including empagliflozin 10 mg, ezetimibe, and trimetazidine.

Implication

Highlights the necessity of aggressive, multifactorial risk factor modification and targeted medical therapy in very high-risk diabetic patients with recurrent coronary artery disease.

Abstract

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Discussion

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Cite This Study

Andrić et al. (2020) conducted a case report in Unstable angina and Type 2 diabetes mellitus (n=1). Multifactorial medical therapy and percutaneous coronary intervention was evaluated.

synapsesocial.com/papers/697854bcccb046adae516e52 https://doi.org/10.5937/siks2011027a

View Full Paper

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Treatment challenges in a very high-risk diabetic patient with coronary artery disease

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Treatment challenges in a very high-risk diabetic patient with coronary artery disease

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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