J Clin Med Res. 2015 Mar;7(3):154-60. doi: 10.14740/jocmr2045w. Epub 2014 Dec 29.
Reduced heart function predicts drug-taking compliance and two-year prognosis in chinese patients with stable premature coronary artery disease.
Journal of clinical medicine research
Zhong Chen, Zhen Ding, Xin Wang, Xiaofeng Zhang, Genshan Ma
Affiliations
Affiliations
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Shanghai 200233,China.
- Department of Cardiology, Zhenjiang First People's Hospital, Zhenjiang 212002, China.
- Department of Cardiology, The Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, China.
- Department of Cardiology, The Affiliated Nanjing Second Hospital of Southeast University, Nanjing 210009, China.
PMID: 25584100
PMCID: PMC4285061 DOI: 10.14740/jocmr2045w
Abstract
BACKGROUND: The purpose of this study was to determine the association between heart function, compliance with drug administration, and the mid-term prognosis in Chinese patients with stable premature coronary artery disease (CAD) (male < 55 years and female < 65 years).
METHODS: The study included 512 patients with stable premature CAD. An estimated glomerular filtration rate (eGFR) calculated using the MDRD formula, baseline clinical characteristics, use of medications for coronary secondary prevention therapies (aspirin, β-blocker, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers, or statins), and 2-year follow-up results, in particular major adverse cardiac events (MACEs), were collected and analyzed.
RESULTS: Patients with reduced left ventricular ejection fraction (LVEF) (18.75%) were more prevalent among men, smokers, those with type 2 diabetes, with a family history of cardiovascular disease (CVD), and with higher white blood cells counts ((8.88 ± 0.35) × 10(9)/L vs. (6.90 ± 0.17) × 10(9)/L) (all P < 0.05) compared to those with preserved LVEF. There was no significant difference between creatinine or eGFR values in the two groups with reduced and preserved LVEF (all P > 0.05). Patients with LVEF < 50% in the MACEs group had a lower ratio of optimal drug administration compared to the MACEs-free group (Z = -0.228, P = 0.820 and Z = -2.167, P = 0.03 respectively). Patients with reduced LVEF had a significantly higher ratio of composite MACEs than patients with preserved LVEF during 2-year follow-up (47.13% vs. 33.50%, P < 0.05).
CONCLUSIONS: Stable premature CAD patients with reduced LVEF have more risk factors, lower medication compliance, and worse 2-year outcomes than those with preserved LVEF.
Keywords: Atherosclerosis; Drug-taking compliance; Left ventricular ejection fraction; Major adverse cardiac events; Premature
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