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January 1, 2022Advanced Biomedical ResearchOpen Access

Assessment of Metabolic Risk Factors and Heart-Healthy Lifestyle in Atherosclerotic Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention after a 6-Month Follow-Up

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Key result

Post-PCI lifestyle education linked to an absolute ~28% increase in physical activity at 6 months.

P=0.019
n=40

Why the study?

Although life-saving interventions have dramatically diminished ACS mortality, metabolic risk factors and heart-healthy lifestyle changes after PCI for a first episode of ACS required assessment.

How do metabolic risk factors and heart-healthy lifestyle behaviors change over 6 months in patients undergoing their first uncomplicated PCI for acute coronary syndrome?

Key Points

To assess metabolic risk factors and heart-healthy lifestyle changes over a 6-month follow-up period in patients undergoing percutaneous coronary intervention following their first acute coronary syndrome episode.
Conducted a longitudinal study tracking N=40 patients following their first acute coronary syndrome event treated with percutaneous coronary intervention.
Assessed demographic variables, physical activity, smoking habits, metabolic equivalent of task (METS), body mass index, waist circumference, and laboratory parameters before discharge and at 6 months.
Physical activity participation increased from 25% to 52.5% (P=0.019), functional capacity (METS) increased from 11.82 ± 2.38 to 12.97 ± 2.43 (P=0.006), and BMI decreased from 28.60 ± 3.54 to 28.11 ± 3.48 (P=0.003).
Lipid profiles paradoxically worsened: LDL-C increased from 66.53 ± 21.47 to 75.55 ± 26.33 mg/dL (P=0.027) and HDL-C decreased from 37.82 ± 8.21 to 35.30 ± 7.26 mg/dL (P=0.013).
Waist circumference (98.59 ± 9.25 vs. 98.13 ± 8.93 cm; P=0.28), smoking rate (32.5% to 22.5%; P=0.12), triglycerides, fasting blood sugar, and blood pressure showed no statistically significant changes (P>0.05).

Study Design

Type

Cohort (n=40)

Multicenter

No

Structured PICO

How do metabolic risk factors and heart-healthy lifestyle behaviors change over 6 months in patients undergoing their first uncomplicated PCI for acute coronary syndrome?

P

Population

40 predominantly male patients (mean age 56.8 years, 7.5% female) undergoing their first uncomplicated PCI with complete revascularization for acute coronary syndrome at a single center in Iran, followed for 6 months.

E

Exposure

Percutaneous coronary intervention (PCI) with face-to-face heart-healthy lifestyle modification training by a cardiology resident and standard secondary prevention pharmacotherapy (95% prescribed statins at discharge)

C

Comparator

Baseline pre-discharge status (single-group longitudinal pre-post comparison)

O

Outcome

Changes in metabolic risk factors and heart-healthy lifestyle parameters (physical activity, METS, BMI, abdominal circumference, smoking status, blood pressure, lipid profile [TG, HDL-C, LDL-C, total cholesterol], FBS, and HbA1C) at 6-month follow-upsurrogate

Main Result

Absolute Event Rate: 52.5% vs 25%

p-value: p=0.019

Limitations

Small sample size limited for generalization
Loss of some samples during follow-up
Short 6-month follow-up duration
Single-center design
Limited population size restricting generalization
Loss of some patients during follow-up
Short follow-up duration of 6 months

Implication

Despite post-PCI improvements in physical activity, functional capacity, and BMI at 6 months, patients experienced paradoxical worsening of LDL-C and HDL-C alongside stagnant smoking and glycemic rates, highlighting gaps in routine secondary prevention.

Abstract

Background: Mortality due to acute coronary syndrome (ACS) has dramatically diminished because of performing life-saving interventions. This study aims to assess the metabolic risk factors and heart healthy lifestyle following the first episode of ACS under percutaneous coronary intervention (PCI) treatment after the 6-month follow-up. Materials and Methods: This is a longitudinal study conducted on 40 patients who underwent PCI because of the first episode of ACS. The patients' information including age, weight, abdominal circumference, smoking, functional capacity, patients' metabolic equivalent of task (METS), and laboratory tests including triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine, fasting blood sugar (FBS), and hemoglobin A1C were recorded before discharge and reassessed after 6-month follow-up. Results: The patients were dominantly male (92.5%) with an average age of 56.8 ± 7.11 years. Physical activity and functional capacity (METS) significantly improved within 6 months ( P = 0.019). BMI significantly improved; however, although the abdominal circumference decreased, it was not significant ( P = 0.28). The number of smokers ( P = 0.12) and the daily number of smoked cigarettes ( P = 0.37) nonsignificantly decreased within 6 months. However, HDL-C ( P = 0.013) and LDL-C ( P = 0.027) changes were not desirable. TG, FBS, and blood pressure did not statistically significant change ( P > 0.05). Conclusion: Although BMI, physical activity, and METS remarkably improved, waist circumference decreased nonsignificantly and lipid profile got worse paradoxically. Although this population is limited for generalization, this study shows that we require further schedules to improve ACS secondary prevention practice in our community.

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Cite This Study

Jazi et al. (2022) conducted a cohort in Acute coronary syndrome undergoing first uncomplicated percutaneous coronary intervention (n=40). Percutaneous coronary intervention and routine face-to-face heart-healthy lifestyle modification training vs. Baseline status before hospital discharge was evaluated on Physical activity participation at 6 months post-PCI (p=0.019).

synapsesocial.com/papers/6add521267b93484cd1798f2 https://doi.org/10.4103/abr.abr_206_20

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