Sudevan Remya, Vasudevan Damodaran, Raj Manu, Thachathodiyl Rajesh, Vijayakumar Maniyal, Abdullakutty Jabir, Thomas Paul, George Vijo, Kabali Conrad
Departments of Health Sciences Research & Cardiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
Department of Health Sciences Research, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India.
BMJ Open. 2020 Oct 10;10(10):e037618. doi: 10.1136/bmjopen-2020-037618.
The primary objective of the study was to report the compliance to secondary prevention strategies for coronary artery disease (CAD), such as smoking cessation, weight management, low-density lipoprotein (LDL) cholesterol control, blood pressure control, glycaemic control, physical activity and cardiovascular drug therapy from a resource-limited setting.
Analytical cross-sectional survey with data collection using questionnaire administered by study personnel.
Institutional-two tertiary care hospitals and two cardiology clinics.
Patients in the age group of 30-80 years with documented CAD with a minimum of 1 year and a maximum of 6 years of follow-up after diagnosis.
The main outcome measures were the prevalence of individual compliance to secondary prevention strategies for CAD such as smoking cessation, weight management, LDL cholesterol control, blood pressure control, glycaemic control, physical activity and cardiovascular drug therapy. The secondary outcomes were the association of secondary prevention strategies with age, sex, domicile, socioeconomic status, insurance and type of treatment.
We recruited a total of 1206 patients among whom 879 (72.9%) were males. The median age of patients was 62 (14) years. The compliance to smoking cessation was 93.86% (95% CI 91.66% to 96.06%), ideal body mass index was 63.76% (95% CI 61.05% to 66.47%), blood pressure control was 65.11% (95% CI 62.42% to 67.80%), LDL compliance was 36.50% (95% CI 33.18% to 39.82%), diabetes control was 51.23% (95% CI 46.10% to 56.36%) and adequate physical activity was 39.22% (95% CI 36.46% to 41.98%)respectively. Reported compliance for cardiovascular drugs therapy was 96% for antiplatelets, 89.4% for statins, 68.2% for beta blockers, 37.7% for renin angiotensin aldosterone system blockers, 81.28% for oral hypoglycaemic agents and 22% for insulin therapy.
Compliance to secondary prevention strategies for CAD in resource limited settings are moderate. This needs further improvement for better outcomes related to CAD in future.
本研究的主要目的是报告在资源有限的环境中，冠心病（CAD）二级预防策略的依从性，如戒烟、体重管理、低密度脂蛋白（LDL）胆固醇控制、血压控制、血糖控制、体育活动和心血管药物治疗。
采用研究人员发放问卷进行数据收集的分析性横断面调查。
两家三级护理医院和两家心脏病诊所。
年龄在30 - 80岁之间，有确诊CAD记录，诊断后随访至少1年且最长6年的患者。
主要观察指标是CAD二级预防策略的个体依从性患病率，如戒烟、体重管理、LDL胆固醇控制、血压控制、血糖控制、体育活动和心血管药物治疗。次要观察指标是二级预防策略与年龄、性别、住所、社会经济地位、保险和治疗类型之间的关联。
我们共招募了1206名患者，其中879名（72.9%）为男性。患者的中位年龄为62（14）岁。戒烟依从率为93.86%（95%可信区间91.66%至96.06%），理想体重指数依从率为63.76%（95%可信区间61.05%至66.47%），血压控制依从率为65.11%（95%可信区间62.42%至67.80%），LDL依从率为36.50%（95%可信区间33.18%至39.82%），糖尿病控制依从率为51.23%（95%可信区间46.10%至56.36%），适当体育活动依从率分别为39.22%（95%可信区间36.46%至41.98%）。报告的心血管药物治疗依从率为：抗血小板药物96%，他汀类药物89.4%，β受体阻滞剂68.2%，肾素 - 血管紧张素 - 醛固酮系统阻滞剂37.7%，口服降糖药81.28%，胰岛素治疗22%。
在资源有限的环境中，CAD二级预防策略的依从性中等。为了未来与CAD相关的更好结果，这需要进一步改善。
