LIFESTYLE PATTERNS AND ADHERENCE TO PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME: A ONE YEAR FOLLOW UP STUDY

Abstract

Background: Acute coronary syndrome is the leading cause of cardiac mortality and morbidity world over. Modification of lifestyle pattern and adherence to pharmacotherapy plays a vital role in primary and secondary prevention of coronary events.

Objective: The purpose of this study was to evaluate the adherence to recommendations for secondary prevention of cardiovascular diseases in patients with acute coronary syndromes (ACS).

Study Design: Prospective hospital-based study done over a period of 2 years.

Participants: 260 patients (204 males & 56 females; mean age ± SD: 55.6±8.27).

Methods: Physical examination, a careful medical interview with assessment for lifestyle habits, adherence to pharmacological therapy and blood analyses were performed in 260 patients at the time of the acute event and then after 3,6 and 12 months of follow-up.

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 and females were 78.6% and 21.5% respectively. Hypertension was a 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 20.4%, 23.1% and 26.5% patients at 3, 6 and 12 months follow up respectively. Uncontrolled diabetes at 3, 6 and 12 months was found in 79.4%, 55.9% and 58.8% patients respectively. Persistence of smoking was present in 3.5%, 6.2% and 8.1% patients at 3, 6 and 12 months respectively. Patients continued to have BMI≥25 were 57.3%, 57.3% and 47.3% at 3, 6 and 12 months respectively. On follow up at 3, 6 and 12 months, 88.1%, 87.7% and 82.7% respectively continued to have a sedentary lifestyle. Dietary non-compliance was observed in 89.2%, 95.0% and 95.8% patients at 3, 6 and 12 months respectively. Drug non-compliance was observed in 3.5%, 3.8% and 6.2% cases at 3, 6 and 12 months follow up respectively. At 3, 6 and 12 month follow up, 75.4%, 81.2% and 84.6% patients respectively continued to have high LDL (≥70 mg/dl).

Conclusion: Adherence to a healthier lifestyle and pharmacotherapy after acute coronary syndrome is significantly low than expected after acute coronary syndrome. These findings demonstrate the difficulty of modifying the lifestyle habits in patients with ACS.

Implication: Adherence to a healthier lifestyle and pharmacotherapy should be encouraged for secondary prevention of acute coronary syndromes.