title: Compliance with pharmacological treatment among patients after minimally invasive coronary bypass grafting.
abstract: BACKGROUND
  We sought to evaluate patients' adherence to optimal pharmacotherapy as recommendedby the European Society of Cardiology, together with the assessment of potential clinical determinants of medical non-compliance in a large cohort of patients after endoscopic atraumatic coronary artery bypassing (EACAB).
  
  
  METHODS
  This cross sectional study was conducted in a group of 706 individuals who underwent EACAB between April 1998 and December 2010. Data covering current pharmacological treatment with antiplatelet agents, beta-blockers (BB) (or heart rate lowering calcium channel blockers [CCB] in case of intolerance and/or poor efficacy of beta-blockade), angiotensin-converting enzyme (ACE) inhibitors (or angiotensin receptor blockers [ARB]) and statins was acquired. Mean duration of observation after the surgery was 2132 ± 1313 days.
  
  
  RESULTS
  Complete follow-up data has been obtained from 415 living patients (341 males). Amongst them, 353 (85%) received antiplatelet agents, while BB or CCB were routinely ingested by 349 (84%) patients. Statins were used by 310 (74.7%) individuals and 274 (66%) subjects took ACE inhibitors or ARB. Baseline demographic and clinical features, including major co-morbidities had no impact on patients' compliance with all investigated medications. There was no clear association between adherence to treatment and risk of rehospitalization or occurrence of major cerebral and cardiovascular events.
  
  
  CONCLUSIONS
  EACAB patients' compliance with pharmacotherapy guidelines is insufficient and is unrelated to demographic and clinical features of the subjects. Multidisciplinary approach involving health education, enhancement in prescription drug affordability and a better rapport between doctors and patients should be incorporated into clinical practice to overcome therapeutic disobedience.
authors: 1st Department of Cardiac Surgery, Medical University of Silesia, University Hospital No. 7, Upper Silesia Medical Center, Katowice, Poland. l.krzych@wp.pl.
authors: Łukasz J
authors: ŁJ
authors: Krzych
authors: Małgorzata
authors: M
authors: Lach
authors: Sara
authors: S
authors: Mustafa
authors: Michał
authors: M
authors: Joniec
authors: Marcelina
authors: M
authors: Niemiec
authors: Maciej
authors: M
authors: Wybraniec
authors: Marek
authors: M
authors: Cisowski
authors: Andrzej
authors: A
authors: Bochenek
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents