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Background Lack of achievement of secondary prevention objectives in patients with ischemic heart disease (IHD) remains an unmet need in this patient population. Aims We aimed at evaluating the 6-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an IHD event. Methods Pilot randomized controlled trial enrolling 78 patients (39 in each arm). A nurse-led intervention including follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, was compared to standard of care in terms of serum lipid-level control at 6 months after discharge. Results The nurse-led intervention was associated with an improved management of LDL cholesterol levels compared to standard of care alone: LDL cholesterol levels ≤100 mg/dL were achieved in 97% participants in the intervention arm as compared to 67% in the standard 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 ≥50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% participants in the intervention arm as compared to 2.6% in the standard 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 objectives in patients with IHD. These findings should be replicated in larger cohorts.

BackgroundSelf-care is an integral component of successful chronic heart failure (HF) management. Structured educational programs have already been shown to be effective in improving self-care, but some patients show resistance and little motivation for change.ObjectiveThe objective of this study was to compare efficacy in improving self-care and health-related quality of life (HRQoL) for an educational intervention based on motivational interviewing (MI) compared with a conventional educational intervention.MethodsThis experimental pretest-posttest study with an equivalent historical control group included 93 patients in the intervention group and 93 matched patients in the control group. Participants attended a first visit after HF hospitalization discharge and 6 to 7 follow-up visits during 6 months. The European Heart Failure Self-care Behavior scale and the Minnesota Living with Heart Failure Questionnaire were used to assess self-care and HRQoL, respectively. Data on mortality and hospital readmissions were collected as adverse events.ResultsSelf-care improved significantly more in the MI-based intervention group than in the control group (P = .005). Although both self-care and HRQoL improved in both groups over time (P < .05), there was no significant between-group difference in terms of HRQoL improvement over time (P = .13).ConclusionsOur findings suggest that MI delivered by MI-trained nurses is effective in significantly improving self-care by patients with HF. Nonetheless, further studies are required to evaluate the impact of MI on other outcomes, such as HRQoL and adverse clinical events.