ABSTRACT
Background: Acute coronary syndrome is the leading cause of cardiac mortality and morbidity world over. Modification of life style pattern and adherence to pharmacotherapy plays a vital role in primary and secondary prevention of coronary events. This study was aimed at assessing the penetration of life style modifications and adherence to pharmacotherapy after acute coronary event in our population.Methods: Acute coronary syndrome patients enrolled in the study were examined, interviewed and all the demographic and clinical data was recorded at index event and at 3, 6 and 12 month intervals.Results: A total of 260 patients were enrolled in the study and followed for 12 months. Mean age of patients was 55.6±8.27 years. Males 78.6% and females 21.5%. Hypertension was risk factor in 67.7%, diabetes in 26.2%, smoking in 63.8%, BMI ≥25 in 67.3% and family history of coronary artery disease in 8.8% of the cases at index event. Uncontrolled hypertension was observed in 30.11%, 38.63% and 44.88% patients at 3, 6 and 12 months follow up. Uncontrolled diabetes at 3, 6 and 12 months was found in 58.82%, 66.17% and 73.52% patients. 5.42%, 15.06% and 21.08% cases continued to smoke at 3, 6 and 12 months respectively. Drug non-compliance overall was noted in 9.61%, 17.69% and 23.84% cases at 3, 6 and 12 month follow up.Conclusions: This study highlights the under prevalence of modifiable risk factor change in practice and drug non-compliance after an acute coronary event.
ABSTRACT
Background This study was conducted to assess the effect of percutaneous coronary revascularization (PCR) on plasma NT-proBNP concentration in patients with chronic stable angina (CSA). Methods This prospective open label interventional study included 22 patients with moderate to severe CSA, normal left ventricular (LV) systolic functions and critical (>90%) proximal stenosis in one of the three major epicardial coronary arteries. After stabilization of medications for 8 weeks, resting supine plasma NT-proBNP levels were measured and patients underwent PCR of the involved vessels. Eight weeks later, with medications unaltered; plasma NT-proBNP levels were repeated and compared with the baseline levels. LV systolic and diastolic functions were assessed before and after PCR. Results The mean age of the patients was 61.27 ± 8.87 years. Out of 22 patients, 20 were male and 2 were female. PCR was performed on left anterior descending coronary artery (LAD) in 12 patients and in a non-LAD vessel in 10 patients. After 8 weeks of successful PCR, there was a significant overall reduction in mean plasma NT-proBNP levels (from 244.36 ± 218.99 to 168.68 ± 161.61 pg/mL, p = 0.016). The patients who underwent PCR of LAD demonstrated significantly reduced NT-pro-BNP levels after PCR (p = 0.009). In the non-LAD group, NT-proBNP levels also decreased, albeit insignificantly (p = 0.432). Reduction in NT-proBNP was independent of change in LV systolic functions. Conclusion Successful PCR, by relieving myocardial ischemia, significantly reduced plasma NT-proBNP levels in majority of the patients with chronic stable angina secondary to critical epicardial coronary artery stenosis.