Level of Adherence to Dual Anti-platelet Therapy at 6 and 12 Months After Coronary Stenting; The Impact on Post-angioplasty Cardiovascular Events

Abstract

Background: Dual antiplatelet therapy (DAPT) following coronary stenting is used to prevent thromboembolic events. Dual antiplatelet therapy discontinuation and poor compliance to the antiplatelet drugs are common and results in various complication, most importantly cardiovascular events. Objectives: Here, we designated a cross-sectional study to evaluate the association of DAPT adherence and post-angioplasty cardiovascular events. Methods: A total of 150 adult patients from Modarres Hospital undergoing successful stent implantation were included and adherence to DAPT following angioplasty were determined via telephone at 6 and 12 months by Persian version of the 8-item Morisky Medication Adherence Scale (MMAS-8). We also recorded the occurrence of ST segment elevation myocardial infarction (STEMI), acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) and re-angioplasty 6- and 12-months following discharge. Results: During the trial, 50 patients were lost to follow-up due to failure to complete the MMAS-8 check list. We analyzed the association of STEMI, ACS, CABG and re-angioplasty with the level of DAPT adherence 6 and 12-month post-angioplasty. Our data suggested an important association of low and high DAPT adherence with lower cardiovascular events at 12 months post- Percutaneous Coronary intervention (PCI). However, at 6 months post-PCI, there was a minor cardiovascular event in patients with moderate DAPT adherence. Conclusions: Here, we observed a significant association of drug adherence along with patient’s risk factors in a course of antiplatelet therapy following coronary stenting.