The benefits of adherence to a heart healthy lifestyle in combination with drug treatment after an acute myocardial infarction treated with coronary artery balloon intervention (PCI) have recently been examined. The Fifth Organization to Assess Strategies in Acute Ischemic Syndromes (OASIS-5) trial showed an up to four-fold reduction of new cardiac events within six months after PCI among patients who followed lifestyle recommendations as compared to those who failed to do so.
The Study of Patient Information after Coronary Intervention (SPICI) investigated the possible gains of a heart healthy lifestyle in a large sample of Swedish patients after PCI (n=1073, 26% females, 74% males, average age 66 years). Within the first two months after PCI patients were asked to report on their current use of tobacco, physical activity and food habits.
The researchers found that although half of the previous smokers had quit, 16% still continued to use tobacco. Following nutritional guidance was reported by 55% but only 40% had changed their dietary habits. Approximately 50% were engaged in regular physical activity, mainly through training sessions in patient groups, but only 31% had actually increased their activity after PCI.
“A possible explanation may be the finding that many patients rated heredity and age as a more plausible cause of their disease than smoking, a lack of physical activity or poor food habits,” said Professor Perk. “Furthermore, a majority reported that as a result of PCI they were cured from the underlying coronary heart disease, thus adding to a lack of interest in changing lifestyle.”
“Each year 18,000 patients undergo PCI in Sweden,” he added. “Using the data from the OASIS-5 study we estimate the expected event rate in the Swedish population during the first half year after PCI to be more than 1,000 new cardiac events (myocardial infarction, stroke and cardiovascular death).”
He continued: “If a 100% compliance to lifestyle recommendations could be reached among our patients instead of the less than satisfactory outcome in the present study there may be major health benefits: one third of the events in Sweden might be prevented annually. That equates to preventing 300 to 400 cardiac events, of which 150 to 200 would have resulted in death.”
Professor Perk concluded: “Current practice after PCI in Sweden needs an in-depth revision. Greater emphasis on lifestyle factors and on methods to support a long-term commitment to behavioural change, are urgently needed.”