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Title: Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial
Author: Ruiz Bustillo, Sonia
Ivern, Consol
Badosa-Marcé, Neus
Farré, Nuria
Marco, Esther
Bruguera, Jordi
Cladellas Capdevila, Mercè
Enjuanes, Cristina
Cainzos Achirica, Miguel
Marti Almor, Julio
Comín Colet, Josep
Keywords: Isquèmia
Malalties del cor
Heart diseases
Issue Date: 1-Jun-2019
Publisher: Sage Publications Ltd.
Abstract: Background and aims: Lack of achievement of secondary prevention objectives in patients with ischaemic heart disease remains an unmet need in this patient population. We aimed at evaluating the six-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an ischaemic heart disease event. Methods: Randomized controlled trial, in which a nurse-led intervention including periodic follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, if appropriate, was compared with standard of care alone in terms of serum lipid-level control at six months after discharge. Results: The nurse-led intervention was associated with an improved management of low-density lipoprotein (LDL) cholesterol levels compared with standard of care alone: LDL cholesterol levels <= 100 mg/dL were achieved in 97% participants in the intervention arm as compared with 67% in the usual care arm (p value <0.001), the LDL cholesterol <= 70 mg/dL target recommended by the 2016 European Society of Cardiology guidelines was achieved in 62% vs. 37% participants (p value 0.047) and the LDL cholesterol reduction of > 50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% of participants in the intervention arm as compared with 2.6% in the usual care arm (p value 0.007). The intervention was also associated with improved blood pressure control among individuals with hypertension. Conclusions: Our findings highlight the opportunity that nurse-led, intensive, post-discharge follow-up plans may represent for achieving LDL cholesterol guideline-recommended management objectives in patients with ischaemic heart disease. These findings should be replicated in larger cohorts.
Note: Versió postprint del document publicat a:
It is part of: European Journal of Cardiovascular Nursing, 2019, vol. 18, num. 5, p. 366-374
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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