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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 Ischemia 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: https://doi.org/10.1177/1474515119831511 |
It is part of: | European Journal of Cardiovascular Nursing, 2019, vol. 18, num. 5, p. 366-374 |
URI: | http://hdl.handle.net/2445/171510 |
Related resource: | https://doi.org/10.1177/1474515119831511 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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