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Fahad Raja khan
Dr Shakeel Ahmed Memon
Dr Samra Rehmat
Dr Bahlool Khan


Coronary artery disease, medication adherence, diabetic patients, coronary stenting, Pakistan, Clopidogrel, Aspirin.


Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide, with a pronounced impact in countries like Pakistan where the burden of cardiovascular diseases is continuously rising. Effective post-procedural management, including medication adherence, is crucial in optimizing outcomes after coronary stenting, particularly in diabetic patients who are at an elevated risk for cardiovascular complications.

Methods: This prospective observational study was conducted at Lady Reading Hospital, Peshawar, from January 1st, 2020, to December 31st, 2021. It aimed to analyze and compare medication adherence and clinical outcomes between diabetic (DM) and non-diabetic (Non-DM) Pakistani patients undergoing coronary stenting. The primary outcome was medication adherence rates, while secondary outcomes included major adverse cardiovascular events (MACE), such as myocardial infarction, stroke, and death. Statistical analyses were performed using SPSS version 26.0.

Results: The study enrolled a total of 3,270 patients, equally divided between DM and Non-DM groups. Medication adherence was impressively high across both groups, with DM patients treated with Clopidogrel showing an adherence rate of 98.0%, slightly higher than the Aspirin group at 97.5%. In Non-DM patients, adherence rates were 98.5% for Clopidogrel and 97.8% for Aspirin. Clinical outcomes were strongly correlated with baseline medication use, and significant differences were noted in the efficacy of Clopidogrel over Aspirin, particularly in diabetic patients.

Discussion: The study confirms the superior efficacy of Clopidogrel over Aspirin in improving clinical outcomes and medication adherence, especially in diabetic patients. These findings suggest that tailored pharmacotherapy could significantly impact patient management post-stenting, advocating for personalized medication strategies based on diabetic status.

Conclusion: This research highlights the importance of medication adherence in managing post-stenting patients and underscores the need for personalized treatment approaches. Clopidogrel should be considered over Aspirin for diabetic patients to reduce the risk of adverse cardiovascular events effectively.

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