Cardiovascular secondary prevention in high-risk patients: a randomized controlled trial sub-study
2015 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 15, 125Article in journal (Refereed) Published
Background: Enhanced cardiovascular secondary preventive follow-up is needed to improve adherence to recommended low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) levels. Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of recurrent events. Secondary prevention is therefore essential in these patients.
Methods: Patients with acute coronary syndrome, stroke, or transient ischemic attack were randomized to nurse-based telephone follow-up (intervention) or usual care (control). LDL-C and BP were measured at 1 month (baseline) and 12 months post-discharge. Intervention patients with above-target values at baseline received medication titration to achieve treatment goals. Values measured for control patients were given to the patient’s general practitioner for assessment.
Results: The final analyses included 225 intervention and 215 control patients with DM or CKD. Among patients with above-target baseline values, the following 12-month values were recorded for intervention and control patients, respectively: LDL-C, 2.2 versus 3.0 mmol/L (p < 0.001); and median systolic BP (SBP), 140 versus 145 mmHg (p = 0.26). Among patients with above-target values at baseline, 52.3% of intervention patients reached target LDL-C values at 12 months versus 21.3% of control patients (absolute difference of 30.9%, 95% CI 16.1 to 43.8%), and there was a non-significant trend of more intervention patients reaching target SBP (49.4% versus 36.8%; absolute difference of 12.6%, 95% CI -1.7 to 26.2%).
Conclusions: Cardiovascular secondary prevention with nurse-based telephone follow-up was more effective than usual care in improving LDL-C levels 12 months after discharge for patients with DM or CKD.
Place, publisher, year, edition, pages
BioMed Central, 2015. Vol. 15, 125
acute coronary syndrome, myocardial infarction, stroke, transient ischemic attack, diabetes mellitus, chronic renal insufficiency, secondary prevention, cardiovascular disease
Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:umu:diva-109784DOI: 10.1186/s12872-015-0115-0ISI: 000363367500003PubMedID: 26466804OAI: oai:DiVA.org:umu-109784DiVA: diva2:859171
8 sidor2015-10-062015-10-062015-11-27Bibliographically approved