Effect of intervention on the control of risk factors in coronary artery disease patients

To assess the effect of optimal medical therapy on the control of risk factors in coronary artery disease [CAD] patients with or with-out intervention. It was a cross sectional comparative study carried out at Lady Reading Hospital, Peshawar January to December 2010. Subjects were divided into two groups based on percutaneous coronary intervention and optimal medical therapy. Study variables were smoking, physical activity, dyslipidemia, diabetes, hypertension and obesity. Informed written consent was taken from all the study participants. Data was recorded on a preformed Questionnaire and analyzed with SPSS version 16. P-value of 0.05 was taken as significant. A total of 315 patients were studied. Baseline characteristic were similar between groups. Smoking was decreased significantly in [PCI group] as compared to [OMT group] [p=0.027]. Physical activity goal >/= 150 min/ week were achieved more in [PCI group] compared to [OMT group][p=0.019]. Goals set for Serum cholesterol, HbA1c%, serum LDL, Systolic blood pressure and Diastolic blood pressure have significantly achieved in [PCI group] as compared to [OMT group] with p- valves of [0.018,0.027,0.023,0.033 and 0.017] respectively. While goals set for Triglycerides, serum HDL and BMI have no significant difference between the two groups with p-valves of [0.223, 0.089 and 0.164 respectively]. Patients who underwent intervention and remained on optimal medical therapy were more adherent to regular exercise and good compliance which lead to better risk factors control for coronary artery disease as compared to patients who remained on optimal medical therapy alone

How successful is secondary prevention for coronary artery disease [cad] in the real world?

To document the effects of secondary prevention on different risk factors in the real world situation. It was a cross sectional comparative study carried out at a referral cardiac clinic in Peshawar from January 2010 to December 2010. Study subjects presenting with at least 6 months follow up were included from different parts of Khyber Pukhtunkhawa. All patients with positive history or objective evidence of CAD were enrolled. Study subjects were divided in two groups based on the fact that either taking or had stopped medication for the duration of the study period. Study variables were levels of lipids, glucose, blood pressure [BP], smoking and obesity. A total of 843 patients were included in the study. Males were 70.4% [593]. Mean age was 58.74 +/- 10.6 years. Patients taking regular medicine were 69.03% while 30.97% had stopped their medicine for at least three months. Diabetics, hypertensive and positive family history for CAD were 33.4%, 50.25% and 24% respectively. When compared to patient who had stopped medicine, mean systolic BP [p= 0.014], diastolic BP [p= 0.05], mean Cholesterol [p=0.000], mean LDL [p=0.000], mean HDL [p=0.000] and HbA1c% [p=0.049], was well controlled in patients who were taking medicine regularly. Mean BMI [p=0.786], triglycerides and smoking [p=0.761] had no significant difference between the two groups. Blood pressure, serum cholesterol, LDL, HDL, as well as HbA1c% were reduced with little effect on serum TGs, BMI and smoking in those who were taking medicine regularly compared to those who had stopped