CLINICAL OUTCOMES IN ANGIOGRAPHIC DOCUMENTEDCORONARY ARTERY DISEASE MANAGED WITH OPTIMALMEDICAL THERAPY IN CURRENT ERA - ONE YEAR FOLLOW UP

Abstract

Background
The management of patients with coronary artery disease (CAD) is complex. There is no study from India showing
clinical outcomes in angiographically documented coronary artery disease in ACS and stable coronary artery
disease in the current era. In most of previous studies only stable CAD patients were enrolled. Therefore the study
is planned in view of above points to assess the outcome in patients with angiographically proven CAD on optimal medical
therapy.
Methods
We conducted Hospital based observational descriptive prospective study involving 106 patients who had objective
evidence of myocardial ischemia and significant coronary artery disease in at least one major epicardial vessel and not
willing for either CABG or PCI, presenting to department of Cardiology, SMS Medical College from march 2013 to nov.
2013 and one year follow up was done till nov.2014. The clinical outcomes were recorded at six month and 12 months
follow up.
Results
Most of the patients were male with a mean age of total patients’ 58.93±11.49 years (range 32 to 83 years). Of these patients,
72 had diagnosis of previously stabilized ACS and 34 had stable coronary artery disease. The baseline characteristics of the
patients were similar in the two groups. 45.28% of patients were symptomatic due to angina at 6 months. At 12 months,
only 24.46% of patients had angina. There were no significant differences between the stabilized ACS group and non-ACS
group in death (overall death 6.6%; 8.3% vs. 2.9%; P = 0.52); hospitalization for acute coronary syndrome (19.4% vs.
11.8%; P = 0.48); or myocardial infarction (overall MI 10.4%; 11.1% vs. 8.8%; P = 0.98), overall hospitalization rates
(27.7%vs. 11.8% P=0.09).
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Open Access Scientific Publisher
International Journal of Medicine & Health Research
IJMHR 46|Volume 1|Issue 2|2015 |
2
Conclusions
Previously stabilized ACS as well as patients with stable coronary artery disease had similar outcomes with OMT so an
initial management approach; optimal medical therapy can be implemented safely in the patients with previously Stabilized
ACS as in patients with stable coronary artery disease