Supervisors info:
Τούτουζας Κωνσταντίνος,Καθηγητής, Ιατρική, ΕΚΠΑ
Κυρίτση Ελένη, Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Summary:
Introduction: The advent of drug eluting stents during angioplasty of coronary arteries, tackled a significant weakness of bare metal stents (BMS), namely restenosis. However, the risk of late and very late stent thrombosis still exists and the prevention of these conditions necessitates administration and prescription of dual antiplatelet therapy. Patients’ adherence to dual antiplatelet therapy consists a basic prerequisite to avoid adverse cardiac events.
Objective: The purpose of this study is to assess the degree of adherence of patients with coronary artery disease in antiplatelet treatment between 1st and 10th month after angioplasty.
Material and Method: The study population consisted of 112 men and women with coronary artery disease who were admitted and hospitalized in ICU of Asklepeion General Hospital in the years 2016-2017 and they were submitted in PCI with implantation of drug eluting stent. A questionnaire was used to assess compliance. In particular, questionnaires were completed by telephone contact at 1st month after angioplasty and at 10th month, respectively. Statistical tests were performed with t-test and ANOVA, considering as the level of significance of 5%. The statistical analysis was performed with the SPSS version 22 statistical package.
Results: Women were more adherent in taking antiplatelet therapy, p=0.030, and it was less frequent for them to omit a dose at 10th month, p=0.014, compared to males. Patients who most often forget to take antiplatelet therapy in the 1st and 10th month are those receiving acetylsalicylic acid and ticagrelor, p=0.001 and p=0.005, respectively. Patients living in a large city more frequently missed a dose on the 1st and 10th month, p=0.008 and p=0.002, respectively. Greater positive adherence was provided by individuals who were well aware of their health problem, p=0.044. Smokers seemed to omit doses of antiplatelet treatment more often, p=0.028, but they were more adherent to dietary instructions in the 1st and 10th month, p=0.033 and p=0.028, respectively. At the 1st month of telephone communication, 30.4% of the sample stated that they neglected or forgot to take an antiplatelet drug, while at the 10th month this percentage significantly increased to 51.8%.
Conclusions: The rates of adherence to dual antiplatelet therapy of patients’ with coronary artery disease, after DES implantation, are generally high at 1st month, however, they significantly decrease at the 10th month after angioplasty.
Keywords:
Adherence, Coronary artery disease, Antiplatelet therapy, Angioplasty, DES.
