BACKGROUND:
One of the main causes of mortality worldwide is Coronary artery disease
(CAD) 1.
In developing countries, cardiovascular diseases caused about eighty
percent of deaths 2. In
2014, CAD was responsible for about 23.14% of total deaths in Egypt3.
Atherosclerosis is the underlying cause of CAD. Inflammation contributes
to the process of atherosclerosis from the plaque formation till its
rupture. Hence, biochemical markers of inflammation were investigated as
noninvasive indicators of underlying atherosclerosis and as a success
marker of therapeutic and preventive
interventions.4
High sensitivity C-reactive protein (hs-CRP) is currently the best
validated inflammatory biomarker. it has become as an independent
predictor of vascular risk similar to systolic blood pressure ,even
more, it was superior to non-HDL-C5.
There has been a positive correlation between levels of hs-CRP, plaque
ruptures risk and coronary artery remodeling grade6. Hence, hsCRP has been
used clinically to detect that risk in both primary and secondary
prevention settings7.
Cardiac rehabilitation programs is a recommended intervention by the
American College of Cardiology the American Heart Association in
reducing coronary events and mortality in CAD patients8.
Cardiac rehabilitation impact on inflammation was previously documented
by the reduction of serum hs-CRP concentrations in CAD patients9.
Despite their benefits, these programs are still underutilized. Although
cardiac rehabilitation programs have significantly lowered CAD
mortality, we are constantly searching for new modalities to further
improve outcome and influence disease progression.
Whereas previous studies have repeatedly proved the favorable effects of
clinical pharmacist interventions on outcomes of chronic diseases
patients 10, none of
these studies have evaluated the impact of clinical pharmacist services
added to cardiac rehabilitation program on inflammatory marker , hs-CRP,
in post-acute coronary syndrome (ACS) patients.
The aim of our study was to assess the impact of clinical pharmacist
services addition to cardiac rehabilitation program, on inflammation and
echo-cardiographic evidence.