Pattern of life style in patients from one subset of rural Tamil Nadu-India, after coronary angioplasty

Type of funding sources: None.

Life after percutaneous coronary angioplasty (PTCA) has been sparsely studied unlike the plethora of studies after coronary bypass surgery (CABG). It is mandatory that the patient make life style changes and be drug compliant, post PTCA in order to improve life expectancy. The magnitude of the life style changes made, also depends to a certain extent on the patient’s age, number of vessels stented, complexity of the coronary anatomy, residual disease in other vessels and associated co morbidities.

This study aimed to assess the pattern of life in patients after elective or emergency PTCA.

One hundred and fifty patients (114 males and 36 females) were reviewed every month for 6 months after PTCA. One hundred and eleven (74%) had co morbidities, the most common being diabetes (DM) and hypertension (HT).

Good drug compliance, to dual antiplatlets (DAPT) and other medications was seen in 83 (55.3%). Irregularity with medications was seen initially in 52 (34.7%), who corrected themselves after further reviews and motivation. Eight (5.3%),were perpetual defaulters and 7(4.7%) were lost to follow up after one or two reviews.

Most of them were farm labourers and rice, continued to be their staple diet even after PTCA, though a handful had switched to foxtail millet (Thinai) or par boiled rice which have a lower glycaemic index. Quantity of rice and oil consumed was however reduced. Majority also avoided deep fried food.

Sixteen(69.6%) of the smokers had stopped smoking after PTCA

One hundred and eighteen(78.7%) post PTCA, in contrast to the 66 (44%) before PTCA, were able to easily walk 300 metres or more in a 6 minute walk test without becoming symptomatic

One hundred and thirty two (88%), had resumed work in one week to 2 months after PTCA, in contrast to 99 (66%) who were able to work before PTCA. Older age, manual labourers, severe LV dysfunction and chronic kidney disease (CKD) contributed to the bulk of work dropouts post PTCA.

Recurrent hospitalisations (>3) occurred in 11(7.3%), and most of them were drug defaulters.

The Left Ventricular function had failed to improve or deteriorated in 8(5.3%), mostly due to residual other coronary vessel disease, poor control of DM or HT, continued smoking or CKD.

One hundred and thirty four (89.3%), enjoyed a better quality of life now, than before PTCA, in terms of reduced or absent symptoms and better functional capacity.

Six(4%) patients underwent further revascularisation. Five had PTCA and one underwent CABG.

Good doctor patient rapport and meticulous patient education following PTCA, plays a pivotal role in reinforcing the importance of drug compliance, life style changes and follow up,as mandatory for stent patency and to avoid recurrent hospitalisations and revascularisations. People who followed a disciplined life post PTCA had better functional capacity, improved quality of life and early return to work.