The effect of self-management program on major adverse cardiac complications of coronary angioplasty

This study was conducted to examine the effect of self-management program on major advers cardiac complications of coronary angioplasty in patients referred to Tohid Hospital in Sanandaj, Iran, in 2018.

Coronary artery disease is the leading cause of death in people over 35 years of age in Iran. Coronary angioplasty is one of the most successful treatment techniques in people with coronary artery disease with some unwanted cardiac complications. Reducing these complications is one of the important goals of health care systems.

This was a quasi-experimental study that was conducted on 101 people with coronary artery disease undergoing angioplasty. The samples were selected by convenience sampling method based on inclusion criteria, and then randomly assigned to the experimental (n=51) and control (n=50) group. Data collection tools included a demographic information questionnaire and a checklist of coronary angioplasty complications. The intervention was implemented in sessions of 45 to 60 minutes duration three times per week in the presence of a family member and a copy was handed in. This intervention was continued for six months in the experimental group. During intervention period, the patient’s condition and the implementation of the self-management program were followed up by phone. The control group received only routine care and the experimental group received both routine care and self-management program. Cardiac complications were assessed in the first, third and sixth months following intervention. Data were analyzed in SPSS version 21 using Chi-square, t-test and generalized estimation equations.

The groups were homogenous in terms of age, gender, marital status, level of education, place of residence, employment status, body mass index, number of children, history of hyperlipidemia, history of diabetes, history of hypertension, history of alcohol consumption, history of heart attack, and type of artery involved. Generalized estimation equations showed that after intervention, the rate of complications of target vessel revascularization (P=0.04), second coronary angioplasty, (P=0.005) and coronary artery bypass graft surgery (P=0.003) were significantly different between the control and experimental groups. However, there were no statistically significant difference between groups in terms of recurrent angina complications (P=0.066), myocardial infarction (P=0.069) and death (P=0.019).

The implementation of self-management program can reduce complications after coronary artery angioplasty. It is recommended for nurses to apply self-management programs and follow-up after discharge  for this group of patients.