What is the commonest site of coronary artery involvement in diabetic patients with coronary artery disease?

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Background: Percutaneous coronary intervention (PCI) is an effective treatment modality of coronary revascularization. Since this is not curative, medication adherence with a better patient satisfaction have a major impact on final clinical outcome. This study aims to assess medication adherence and patient satisfaction following PCI.

Background and ObjectivesAmbulatory blood pressure monitoring (ABPM) is more reflective of an individual's blood pressure (BP) profile and its control, eliminating several confounding and contributory factors. This study looked at the circadian pattern of BP variation with respect to nocturnal BP fluctuations and compared clinic BP measurements with ambulatory readings in patients on treatment for essential hypertension Methods A prospective study was conducted at Teaching Hospital, Kandy from August to October 2015. The study participants were 100 patients, above 18 years of age, with stage I to III essential hypertension with normal renal functions and having no history of coronary or cerebro-vascular events. All patients underwent electrocardiography, 2D echocardiography, manual BP measurement and 24-hour ambulatory blood pressure monitoring. ResultsThere was a female preponderance 72(72%) and the mean age was 61 ± 9 years. One third had uncontrolled BP, according to clinic BP readings, whereas 60% had uncontrolled BP according to ambulatory blood pressure monitoring. The agreement between the office BP and ABPM in diagnosing controlled or uncontrolled BP was low (58%, Kappa = 0.23). A significant statistical difference (p<0.001) was observed between day and night time measurements, irrespective of BP control. In the sample, 70% had abnormal dipping patterns including non-dipping (45%), reverse dipping (25%) and extreme dipping (5%). Conclusions and RecommendationsABPM is more reflective of an individual's naïve BP pattern. It captures the different types of diurnal variation of BP thus guiding the physician to treat the patient optimally. Moreover, its noninvasive and portable nature allows it to be used with ease. It is likely that ABPM will gather widespread recognition and acceptance as a more reliable diagnostic and prognostic tool in the future