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Cardiovascular secondary prevention in high-risk patients: a randomized controlled trial sub-study

Stina Jakobsson1, Anna-Lotta Irewall2, Fredrik Bjorklund3

  • 1Department of Public Health and Clinical Medicine, Division of Medicine, Ostersund sjukhus, Umea University, Umea, Sweden. stina.jakobsson@umu.se.

BMC Cardiovascular Disorders
|October 16, 2015
PubMed

Insights

Nurse-based telephone follow-up significantly improved low-density lipoprotein cholesterol (LDL-C) levels in high-risk patients with diabetes mellitus (DM) or chronic kidney disease (CKD) 12 months post-discharge.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Trials
  • Health Services Research

Background:

  • Enhanced cardiovascular secondary preventive follow-up is crucial for improving adherence to recommended low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) levels.
  • Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) face elevated risks of recurrent cardiovascular events, necessitating effective secondary prevention strategies.

Purpose of the Study:

  • To evaluate the effectiveness of nurse-based telephone follow-up compared to usual care in improving LDL-C and BP levels in patients post-acute coronary syndrome, stroke, or transient ischemic attack.

Main Methods:

  • Randomized controlled trial involving patients with DM or CKD after acute coronary syndrome, stroke, or transient ischemic attack.
  • Intervention group received nurse-based telephone follow-up with medication titration; control group received usual care.
  • LDL-C and BP were measured at baseline (1 month) and 12 months post-discharge.

Main Results:

  • Among patients with above-target baseline LDL-C, 52.3% in the intervention group achieved target levels at 12 months versus 21.3% in the control group (p < 0.001).
  • Median systolic BP (SBP) at 12 months was 140 mmHg for the intervention group and 145 mmHg for the control group (p = 0.26).
  • A non-significant trend showed more intervention patients reaching target SBP (49.4% vs. 36.8%).

Conclusions:

  • Nurse-based telephone follow-up is a more effective strategy than usual care for improving LDL-C levels in high-risk patients with DM or CKD 12 months post-discharge.
  • The intervention showed a positive trend in improving SBP, warranting further investigation.
Abstract

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