ANTIPLATELET ADHERENCE AT SIX MONTHS AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION PERFORMED AT A RURAL SATELLITE CENTER
Objectives: To determine the frequency of dual antiplatelet adherence at six months after primary PCI performed at rural satellite center.
Methodology: This was a descriptive study conducted at Rural Satellite Center (Larkana) of the National Institute of Cardiovascular Disease, Pakistan from October 2017 to March 2018. Patients of either gender between the ages of 20-80 years who underwent primary Percutaneous Coronary Intervention (PCI) at least six months ago were included in this study. Compliance with antiplatelet therapy was assessed by interview at follow up. Patients were labeled as compliant if they took both aspirin and clopidogrel at the time of follow up at six months.
Results: Of the total of 241 patients, 208 (86.3%) were male. The mean age of the patients was 53.37 ± 11.07 years. Hypertension was present in 170 (70.5%), 101 (41.9%) were diabetic, 104 (43.2%) were smokers and 18 (7.5%) were obese. The most common culprit artery was left anterior descending (LAD) artery, 149 (61,8%), followed by the right coronary artery (RCA) in 83 (34.4%) patients. Nearly 12.1% (31) patients had the three-vessel disease, whereas, 53.9% (130) patients had single-vessel involved. Compliance with antiplatelet therapy at six months was found to be 89.6%, 219 (90.9%) were compliant to aspirin while 218 (90.5%) were compliant to clopidogrel.
Conclusion: In our population, a significant number of patients (10.4%) were not compliant with dual antiplatelet therapy after six months of primary PCI. The dual antiplatelet adherence, in our population, is lower than in developed countries. Therefore, efforts should be made to increase compliance.Keywords: ACS, Aspirin, clopidogrel, Dual antiplatelet, Myocardial infarction
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