Adherence to the main prognosis-modifying drugs and the control of risk factors for coronary artery disease in patients after coronary stenting

Abstract

BACKGROUND: Adherence to drug therapy in patients with coronary artery disease is quite low nowadays, both in patients with myocardial infarction and in patients with chronic forms of coronary artery disease.
 AIMS: of our work was to assess adherence to drug therapy (aspirin and statins) and control of risk factors for coronary artery disease in patients undergoing coronary stenting 12 months after endovascular treatment.
 MATERIALS AND METHODS: The study included 279 patients, of whom 3 groups were formed. Patients of group 1 (n=96) personally visited the National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, adherence to the prescribed therapy and its effectiveness were assessed during the examination by a cardiologist, and if necessary, it was corrected. Patients of group 2 (n=95) contacted the study coordinator remotely. Patients of group 3 (n=88) were monitored by a general practitioner and visited a cardiologist at the National Medical Research Center of Cardiology according to the decision of the general practitioner.
 RESULTS: At baseline, adherence to therapy in all groups was low and did not differ significantly between groups. 12 months after stenting, groups 1 and 2 showed a significant increase in the number of highly adherent individuals (from 17 to 33 and from 13 to 42, respectively, p 0.05), as well as a significant decrease in the number of individuals with low adherence to treatment (from 63 to 42 and from 67 to 36, respectively, p 0.05). The adherence to antiplatelet drugs was higher than to statins: 57.9% of people reduced the dose or stopped taking statins. After the follow-up time, there was a significant decrease in systolic blood pressure in groups 1 and 2 and a significant decrease in diastolic blood pressure in group 2. In group 2, a significant decrease in the number of smokers was noted: from 46.3 to 31.6% of the total number of patients in the group (p 0.05).
 CONCLUSION: Active monitoring of patients by a cardiologist both during the visit and remotely contributes to an increase in adherence to drug therapy and improves control of risk factors for coronary artery disease.