oa Cardiovascular Journal of Africa - Asymptomatic coronary artery disease in diabetics with end-stage renal failure the need for a reliable diagnostic technique



Diabetics with end-stage renal disease have a high prevalence of silent coronary artery disease (CAD). This increased cardiovascular risk and the subsequent premature death from CAD of many diabetic renal transplant recipients are of concern, as the end result is both financial loss and allograft waste. Standard exercise stress testing is frequently inconclusive and coronary angiography may be difficult to justify in these asymptomatic patients. Dipyridamole-radionuclide imaging and dobutamine stress echocardiography are two non-invasive diagnostic techniques which may be used for the detection of CAD in patients who are unable to exercise. Further research needs to be undertaken in South Africa in order to gain expertise with these techniques and to develop guidelines for the management of these high-risk patients.


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