Adherence to non-medication treatment in patients undergoing coronary artery bypass surgery

Abstract

Purpose: Examine perioperative dynamics of adherence to non-medication treatment in patients undergoing coronary artery bypass surgery (CABG). Material and methods: 320 consecutive patients aged 38-75 years, 267 males and 53 females with stable ischemic heart disease (IHD) undergoing CABG were enrolled in the study. The patients were examined 5-7 days before CABG and 1 year after the surgery. Physical examination was done, laboratory data (lipids, HbA1c) were taken from the medical records. The study used the questionnaire made by the authors, this questionnaire reflected eating habits and physical activity before CABG and 1 year after the surgery and was completed by the patients. The data were statistically analyzed using the Statistica 6.0 software. Results: Patients undergoing CABG turned out to be non-motivated for secondary prevention. Indeed, the assessment of modified cardiovascular risk factors showed that out of 138 (43%) patients who had smoked before CABG only 29 (9%) of patients quit smoking after the surgery. 68% of patients had abdominal obesity before CABG and this number increased by 8% 1 year after the surgery. The number of patients who changed their eating habits and started physical exercise did not change either. The number of patients whose arterial hypertension got compensated 1 year after CABG did not increase statistically (from 58% to 61%, p=0.665). 1 year after CABG there were 30% (96 patients) less patients with high total cholesterol levels (p<0.001). A significant decrease in total cholesterol (from 5.57±1.36 to 4.67±1.12 mmol/L, p<0.001) and low density lipoprotein levels (from 3.31±1.23 to 2.83±0.95 mmol/L, p=0.013) was observed. However, the mean target levels were not reached. The same tendency was seen in the target levels of HbA1c in diabetic patients: only 34% patients reached these levels after the surgery. Conclusions: Despite the fact that the benefits of secondary prevention measures and risk factors control in severe IHD patients is well-known, the patients' adherence to postoperative recommendations is not enough and it is mostly about the way of life changes. Even the patients, who adhere to the recommendations, are not always able to achieve the main goals of secondary prevention.