HOW SUCCESSFUL IS SECONDARY PREVENTION FOR CORONARY ARTERY DISEASE (CAD) IN THE REAL WORLD?

Abstract

Objective: To document the effects of secondary prevention on different risk
factors in the real world situation.
Methodology: 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.
Results: 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.
Conclusion: 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.