Browsing by Author "Silva, S.B.K."

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    Prevalence of antiplatelet use for primary prevention of cardiovascular diseases and its' justification among an urban Sri Lankan cohort of patients with cardiovascular risk factors
    (Sri Lanka College of Internal Medicine, 2019) Mettananda, K.C.D.; Silva, S.B.K.; Thampoe, R.S.; Batagoda, B.M.S.M.
    BACKGROUND: Guidelines on aspirin for primary prevention of cardiovascular diseases (CVD) has changed. There are no data on aspirin use for primary prevention from Sri Lanka or South Asia. OBJECTIVES: We aimed to describe antiplatelet use in primary prevention and its' justification in relation to latest guidelines in a cohort of patients with CV risk factors attending a follow-up medical clinic since 2007 of a community surveys of urban Sri Lanka. METHODS: A descriptive study was conducted of all patients with CV risk factors but without previous CVDs attending the above clinic from March 2018 -March 2019. Data were collected using an interviewer administered questionnaire. Patients' 10-year CV risk was calculated with WHO charts (SEAR B). Data were analyzed using SPSS-version 22. RESULTS: 170(137(80.6%) female, mean age 66.0± (6.70) years) were studied. Prevalence of CV risk factors; diabetes-mellitus, hypertension, hyperlipidemia and smoking were 80(47.1%), 114(67.5%), 150(89.3. %), 4(2.4%) respectively. 24(14.1%) were on antiplatelet for primary prevention. All were on aspirin. Aspirin prescription was justifiable in 4(25.0%) who were 50-69 years and had a 10-year CV risk of more than 10% according to US preventive task force recommendations. However, 7(16.3%) patients aged 70-years or more were on antiplatelet without justification. None of the patients have had serious adverse effects with aspirin. However, 50% had symptoms of gastritis. CONCLUSIONS: Even though antiplatelet use for primary prevention is not common in this cohort of urban Sri Lankans, a significant proportion of elderly were on antiplatelet without justification. Further, half of the patients experienced symptoms related to antiplatelet related side effects.
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    Statin use in primary prevention of cardiovascular diseases among an urban Sri Lankan cohort of patients with cardiovascular risk factors
    (Sri Lanka College of Internal Medicine, 2019) Mettananda, K.C.D.; Silva, S.B.K.; Thampoe, R.S.; Batagoda, B.M.S.M.
    BACKGROUND: Guidelines on statin prescription for primary prevention of cardiovascular diseases (CVD) have changed. However, there is limited data on use of statin in primary prevention among Sri Lankans. OBJECTIVES: We aimed to describe statin use in primary prevention of CVD in relation to 2018 AHA guidelines among an urban Sri Lankan cohort of patients with cardiovascular risk factors. METHODS: All patients without previous CVD but having vascular risk factors attending a follow-up medical clinic of a community surveys of urban Sri Lanka were studied from March 2018-2019. Data were collected using an interviewer administered questionnaire. Patients' 10-year CV risk was calculated using WHO/ISH charts (SEAR B). LDL targets were defined as <70 mg/dl - high risk, <100 mg/dl - intermediate risk and <130mg/dl - low risk patients on AACE 2017 Guidelines. Data were analysed using SPSS-version22. RESULTS: Total of 170 subjects (mean age 66.0±6.70years) were studied and of them 137(80.6%) were females. 129(75.9%), 26(15.3%), 15(8.8%) were at low, intermediate and high risk of CVD respectively. Prevalence of CV risk factors; diabetes mellitus, hypertension and smoking were 80 (47.1%), 114(67.5%), 4(2.4%) respectively. 152(89.4%) were on statins and 110(72.4%) had LDL controlled to target. 87% (70) of diabetics were on statins and 68%.,48) had LDL 190mg/dl were on statins. CONCLUSIONS: Even though statin prescription in primary prevention is satisfactory, a significant proportion has not met the treatment goals in this Sri Lank.an cohort.