Manipal lifestyle modification score to predict major adverse cardiac events in postcoronary angioplasty patients

Devasia, Tom and Shetty, Prasad Narayana and Kareem, Hashir and Rao, Yeswanth Karkala and Singh, Ajit (2018) Manipal lifestyle modification score to predict major adverse cardiac events in postcoronary angioplasty patients. Indian Heart Journal, 70 (3). pp. 353-358. ISSN 0019-4832

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Abstract

Background: Lifestyle modification (LSM) such as prudent diet, physical activity, avoidance of smoking,and maintaining a healthy weight may considerably decrease the risk for coronary artery disease.Objective: The primary objective of this study was to develop a new LSM scoring system and investigate the correlation between adherence to LSM and incidence of major adverse cardiac events (MACEs) at 12-month follow-up.Method: A total of 1000 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were included in this prospective single-center study. Manipal lifestyle modification score (MLSMS) was developed by using five lifestyle-related factors. Adherence to LSM at the baseline and subsequent follow-ups was determined by using MLSMS. The MACE at 1-, 6-, and 12-month followup were analyzed.Results: There was a significant reduction in overall adherence to LSM (p < 0.001) at 12-month followup. Nonadherence to LSM [hazard ratio (HR) 0.575; 95% confidence interval (CI) 0.334e0.990; p < 0.046] and noncompliance to medication (HR 2.09; 95% CI 1.425e3.072; p < 0.001) were independent predictors of MACEs after PTCA. The cumulative MACE was 15.4%, which includes 4.9% of all-cause death, 5.2% of nonfatal myocardial infarction, 2.0% of target lesion revascularization, 1.8% of target vessel revascularization,and 1.3% of stroke at 12 months. The incidence of MACEs at 12 months was significantly (p ¼ 0.03)higher in LSM nonadherent compared with LSM adherent patients.Conclusion: There is an overall reduction in adherence to LSM on successive follow-ups and a significant association between the incidence of MACEs and the lack of adherence to LSM. MLSMS is a simple and effective evaluation tool in predicting MACEs in this group of patients.

Item Type: Article
Uncontrolled Keywords: Coronary heart disease; Lifestyle modification; Percutaneous coronary interventions
Subjects: Medicine > KMC Manipal > Cardiology
Medicine > MMMC Manipal > Pharmacology
Depositing User: KMC Library
Date Deposited: 23 Jan 2019 04:05
Last Modified: 23 Jan 2019 04:05
URI: http://eprints.manipal.edu/id/eprint/153102

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