The effects of implementation of guideline-directed medical therapy on relief of angina in patients with stable coronary artery disease in Serbia
Introduction. Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD) is poor. Objective. We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Serbian Medical Society
2016-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2016/0370-81791612590I.pdf |
| Summary: | Introduction. Adherence to proposed lifestyle changes and prescribed
medication in patients with stable coronary artery disease (SCAD) is poor.
Objective. We sought to investigate the influence of adjusting guideline
proposed medications on relief of angina in a large group of patients with
SCAD in Serbia. Methods. The study included a total of 3,490 patients from 15
cardiology clinics with symptoms of stable angina and at least one of the
following criteria: abnormal electrocardiogram (ECG), history of myocardial
infarction (MI), positive stress test, significant coronary artery disease on
coronary angiogram or previous revascularization. All the patients underwent
comprehensive evaluation at initial visit and after two months. The relief of
angina was study end-point defined as any reduction in Canadian Cardiology
Society (CCS) class, number of angina attacks per week and/or number of
tablets of short-acting nitrates per week. Results. Most patients were
included based on abnormal ECG (48.4%). At Visit 1, the average number of
prescribed classes of medications to a single patient increased from 4.16 ±
1.29 to 4.63 ± 1.57 (p < 0.001). At the follow-up, the patients had
significantly lower blood pressure (141 ± 19 / 85 ± 11 vs. 130 ± 12 / 80 ± 8
mmHg; p < 0.001) and most of them reported CCS class I (63.3%). The average
weekly number of angina attacks was reduced from 2.82 ± 2.50 at Visit 1 to
1.72 0 ± 1.66 at Visit 2, as well as average weekly use of short-acting
nitrates to treat these attacks (2.69 ± 2.53 to 1.74 ± 1.47 tablets; p <
0.001 for all). Conclusion. Adjustment of prescribed medications to guideline
recommendations in a large Serbian patient population with prevalent risk
factors led to significant relief of angina. |
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| ISSN: | 0370-8179 2406-0895 |