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Introduction and Aim
Coronary artery disease (CAD) is the most frequently seen form of heart diseases. Globally, it is the leading cause of mortality in both gender. In recent years, there have been new improvements in the medical treatment of CAD. In most of the patients medical therapy is found to be more effective than revascularization therapies. In order to increase the success of treatments, therapies should be applied in accordance with the guidelines and the objectives in these guidelines should be achieved. In this study, we evaluated the patients, with angiographically documented coronary artery disease who were followed in our outpatient clinic and applied for the drug therapy re-arrangement after the withdrawal of medium acting nitrates. The aim of this study is to evaluate the treatments used and drug efficacy in these patients.
72 patients (42 male, 30 female; age 67±18 years) were evaluated in this study. These patients were diagnosed CAD with coronary angiography and were followed in our outpatient clinic. After the withdrawal of medium acting nitrates these patients were examined again in the secondary care cardiology ouypatient clinic for drug therapy rearrangement. Patients were divided into three groups; 22 patients (30,6%) were using medical therapy, 20 patients (27,8%) had Percutaneous Coronary Intervention (PCI), 30 patients (41,7%) had coronary artery bypass graft (CABG) operation. Patients’ clinical, demographic profile and medical treatments were recorded.
: 19 patients (26,4%) were diabetic, 59 were (81,9%) hypertensive and 29 were (35,3%) smokers. 49 patients (68,1%) were using angiotensin converting enzyme inhibitors (ACE inh.), 57 were (79,2%) using beta blockers (B blk.), 26 were (36,1%) using statins, 70 were (97,2%) using acetylsalicylic acid (ASA) and 20 were (27,8%) using calcium channel blockers (CCB). We have found statistically significant difference between three groups in use of ACE inhibitors (p=0.018). When we analyzed, we found that this statistically significant difference was caused by the lesser usage of ACE inh. in the CABG group. We also found statistically significant difference in statin use between three groups (p<0.001).
This study showed that in our country, drugs such as ACE inhibitors, statins and beta blockers, which are proven to have favourable effects on mortality, have been used far less than the guidelines’ recommendations, however the patient group who had PCI seems to do better in reaching these goals. In the hospitalization period, which is important for patients compliance, patients and doctors should gain consciousness about these agents and encourage the usage of these agents.