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Effectiveness of coronary heart disease risk management in high-risk patients
T Leitha1, A Staudenherz, B Bachmann
1University Clinic of Nuclear Medicine, Vienna, Austria.
Insights
A patient-based coronary heart disease (CHD) risk management strategy showed improved lipid profiles and CHD risk indices. However, high dropout rates limited long-term compliance and prognostic factor identification.
Area of Science:
- Cardiology
- Preventive Medicine
- General Practice
Background:
- Coronary Heart Disease (CHD) poses a significant public health challenge.
- Effective risk management strategies are crucial for preventing CHD.
- Current general practice approaches may have limitations in managing complex CHD risk factors.
Purpose of the Study:
- To evaluate the effectiveness of a patient-based CHD risk management strategy.
- To analyze the outcomes of patients referred to a specialized center for refractory CHD risk.
- To assess the impact of dietary/drug treatment on lipid profiles and CHD risk indices.
Main Methods:
- A cohort of 452 patients with CHD risk factors was studied.
- 152 patients with secondary hyperlipidemia were excluded.
- 300 patients underwent a 12-month food protocol-monitored dietary/drug treatment.
- Lipid profiles and CHD risk indices were monitored.
- Patient compliance was assessed.
Main Results:
- The food protocol-controlled treatment improved lipid profiles and CHD risk indices compared to pre-treatment.
- Patient compliance with the treatment protocol was 80.3%.
- Long-term CHD risk reduction was observed in compliant patients for 12 months.
- A significant cumulative dropout rate was observed (43% at 6 months, 68% at 12 months).
- No consistent prognostic factors for long-term compliance were identified.
Conclusions:
- Patient-based CHD risk management, including dietary and drug interventions, can be effective in improving risk factors.
- Early referral and underutilization of treatments in general practice may hinder optimal patient outcomes.
- High patient dropout rates pose a challenge to sustained risk reduction.
- Further research is needed to identify factors promoting long-term compliance in CHD risk management.
Abstract:
The purpose of this study was to investigate the efficacy of the patient-based coronary heart disease (CHD) risk management strategy in general practice by analyzing patients who were sent to a specialized center as refractory to conventional treatment. Of the 452 patients studied, 152 were excluded because of secondary hyperlipidemia. The effects of a food protocol-monitored dietary/drug treatment on lipid profiles and CHD risk indices and the compliance to this approach were monitored for 12 months in 300 of 452 patients. CHD risk classification was performed according to NIH criteria by the referring physicians, but secondary hyperlipidemia was not identified and treated appropriately. Physicians did not fully utilize dietary and drug treatment and referred the patients to a specialized center too early. The initiated food protocol-controlled treatment was more efficient than pretreatment in general practice, with a compliance of 80.3% by patients selected according to their CHD risk. Long-term CHD risk reduction was persistent for 12 months in compliant patients; however, a cumulative dropout rate of 43% after 6 months and of 68% after 12 months was noted. Statistical analysis failed to reveal consistent prognostic factors of long-term compliance.