Koroner arter hastalığı olanlarda medikal tedavi ve yaşam tarzı değişikliklerine uyumun değerlendirilmesi

Öz

Amaç: Koroner arter hastalığı (KAH) için sekonder korumada medikal tedavi (MT) yaşam tarzı değişikliklerine
(YTD) uyum hastalığa bağlı mortalite ve morbiditeyi azaltmaktadır. Bu çalışmada KAH hastalarında MT ve
YTD’ye uyumu etkileyen parametrelerin araştırılması amaçlanmıştır.
Gereç ve yöntem: En az bir yıl önce farklı sebeplerle koroner anjiografi yapılarak KAH tanısı almış ardışık 396
hastaya uyumu değerlendirmek üzere standardize edilmiş anket uygulanmıştır.
Bulgular: Hastaların %20,9’u (n=83) YTD’ye uyumsuz, %42,4’ü (n=168) orta derecede uyumlu, %36,6’sı
(n=145) uyumlu saptanmıştır. %81,1’i ise (n=321) MT’ye tam uyumlu saptanmıştır. Erkek cinsiyet (RA:1,966,
p=0,023), daha genç yaş (yaş, RA:0,958, p=0,002), KABG yapılması YTD’ye uyumu arttırırken (RA:2,635,
p=0,015), ST elevasyonsuz miyokart enfarktüsü/unstabil angina pektoris nedeniyle koroner anjiografi yapılmış
olması (RA:0,344, p=0,001) ve ST elevasyonlu miyokart enfarktüsü/ölümcül aritmi nedeniyle koroner anjiografi
yapılmış olması (RA:0,472 p=0,014) YTD’ye tam uyumluluk üzerine negatif etkilidir. Hipertansiyon varlığı
(RA:5,779 p<0,001), ST elevasyonlu miyokart enfarktüsü/ölümcül aritmi (RA:3,736, p=0,029) varlığı MT’ye
uyumu arttırırken, perkütan koroner girişim uygulanması (RA:0,132, p=0,002) MT’ye uyumu azaltmaktadır.
Sonuç: Ülkemizde KAH hastalarında MT’ye uyum YTD’ye uyumdan daha yüksektir. Genç yaş erkek hastalar
YTD’ye daha fazla uyum sağlarken bu etki MT’de saptanmamıştır. Gelir düzeyinin orta ve yüksek olması YTD’ne
uyumu pozitif yönde etkilerken

Anahtar Kelimeler

• Yaşam tarzı değişikliklerine uyum
• medikal tedaviye uyum
• koroner arter hastalığı

Evaluation of adherence to medical treatment and lifestyle changes at coronary artery disease

Abstract

Purpose: Adherence to medical treatment (MT) and lifestyle changes (LC) in secondary prevention for coronary
artery disease (CAD) reduces disease-related mortality and morbidity. In this study, we aimed to investigate the
parameters affecting compliance with MT and LC in patients with CAD.
Material and method: A standardized questionnaire was applied to 396 consecutive patients who were
diagnosed with CAD by performing coronary angiography for different reasons at least one year ago, to evaluate
adherence.
Results: 20.9% of the patients (n=83) were found to be non-adherent to LC, 42.4% (n=168) were intermediateadherent,
and 36.6% (n=145) were adherent. 81.1% (n=321) of the patients were found to be fully adherent
to MT. Male gender (CI:1.966, p=0.023), younger age (age, RA:0.958, p=0.002), performing coronary artery
bypass grafting (CI:2.635, p=0.015) increased adherence to LC, conversely non-ST elevation myocardial
infarction/unstable angina pectoris (CI:0.344, p=0.001) and ST-elevation myocardial infarction/fatal arrhythmia
(CI:0.472 p=0.014) decreased adherence. Presence of hypertension (CI:5,779, p<0.001), ST-elevation
myocardial infarction/fatal arrhythmia (CI:3.736, p=0.029) increased adherence to MT but percutaneous
coronary intervention (CI:0.132, p=0.002) decreased adherence to MT.
Conclusion: Adherence to MT is higher than LC in patients with CAD in our study population. Younger
male patients were more adherent to LC but this effect was not observedadherence to LC. The medium and
high-income level positively affected

Keywords

• Adherence to medically treatment
• adherence to lifestyle changes
• coronary artery disease

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