To access this material please log in or register

Register Authorize

Patient compliance with long-term clopidogrel antiplatelet therapy following interventional therapy for ischemic heart disease

Manchenko I. V., Bobrov A. L., Sedova E. V., Obrezan A. G.

Keywords: double antiplatelet therapy, coronary heart disease, acute coronary syndrome, non st-elevation acute coronary syndrome, treatment compliance, angina, transcutaneous coronary intervention

DOI: 10.18087/rhj.2013.5.1835

Background. Low compliance with treatment after coronary interventions results in major cardiovascular complications. Aim. Evaluating the compliance of IHD patients with their antiplatelet therapy; determining the actions which would increase the patient compliance. Materials and methods. 40 patients with stable exertional angina and 16 patients with ACS were evaluated. All patients underwent coronary balloon angioplasty with stent placement. Double antiplatelet therapy (DAT) for one year after the intervention was recommended. After 12 months, the number of visits for the one-year follow-up period was counted. Results. The mean duration of using DAT was shorted than desired, 8.9±3.0 months for patients with angina and 10.1±3.1 for patients with OCS. The percentage of patients compliant with DAT after 12 months was lower in the HF group (35 %) than in the OCS group (63 %). A moderate correlation (r=0.5) between the number of follow-up visits to cardiologists and the treatment duration was observed. Conclusion. The obtained data confirm the need for better contacts between the patient and the cardiologist, who has performed the intervention, to improve the patient compliance with the prescribed long-term treatment. At follow-up visits after the transcutaneous coronary intervention, the doctor should stress the disease seriousness and strongly recommend strict compliance with the duration of antiplatelet therapy.
  1. Rossini R, Capodanno D, Lettieri C et al. Prevalence, predictors, and long-term prognosis of premature discontinuation of oral antiplatelet therapy after drug eluting stent implantation. Am J Cardiol. 2011;107 (2):186–194.
  2. Broderick JP, Bonomo JB, Kissela BM et al. Withdrawal of antithrombotic agents and its impact on ischemic stroke occurrence. Stroke. 2011;42 (9):2509–2514.
  3. Boden WE. Weighing the evidence for PCI decision-making in patients with stable CAD. Circulation. 2012;125 (15):1827–1831.
  4. Hannan EL, Samadashvili Z, Cozzens K et al. Comparative outcomes for patients who do and do not undergo percutaneous coronary intervention for stable coronary artery disease in New York. Circulation. 2012;125 (15):1870–1879.
  5. Sianos G, Morel MA, Kappetein AP et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2005;1 (2):219–227.
  6. Cheng CI, Chen CP, Kuan PL. The causes and outcomes of ina­dequate implementation of existing guidelines for antiplatelet treatment in patients with acute coronary syndrome: the experience from Taiwan Acute Coronary Syndrome Descriptive Registry (T-ACCORD Registry). Clin Cardiol. 2010;33 (6):40–48.
  7. Шуленин C. Н., Хубулава Г. Г., Бобров А. Л., Манченко И. В. Диагностика сердечной недостаточности с помощью стресс–эхокардиографии. Вестн. Российской Военно-медицинской академии. 2010;3:21–25.
  8. Ahmad WA, Ramesh SV, Zambahari R. Malaysia ACute CORonary syndromes Descriptive study (ACCORD): evaluation of compliance with existing guidelines in patients with acute coronary syndrome. Singapore Med J. 2011;52 (7):508–511.
  9. D'Agostino RB Sr, Vasan RS, Pencina MJ et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117 (6):743–753.
Manchenko I.V., Bobrov A.L., Sedova E.V. et al. Patient compliance with long-term clopidogrel antiplatelet therapy following interventional therapy for ischemic heart disease. Russian Heart Journal. 2013;12(5):295-298

To access this material please log in or register

Register Authorize
Ru En