Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial

Ruíz-Bustillo, Sonia; Ivern, Consol; Badosa, Neus; Farré, Núria; Marco, Esther; Bruguera, Jordi; Cladellas, Mercè; Enjuanes, Cristina; Cainzos‐Achirica, Miguel; Martí‐Almor, Julio; Comín‐Colet, Josep

doi:10.1177/1474515119831511

Cited by 11 publications

(10 citation statements)

References 26 publications

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“…Recent surveys indicated that there is considerable potential for further improvements in the secondary prevention of CAD in European countries [11][12][13]. Many intervention methods aimed at improving secondary prevention in CAD patients have been proposed previously [14][15][16][17][18][19]. Additionally, several factors influencing the quality of secondary prevention in every-day practice have been identified [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey

Jankowski

Kozieł

Setny³

et al. 2021

JCM

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Lipid-lowering in patients with coronary artery disease (CAD) is related to a lower risk of cardiovascular events. We evaluated factors related to the management of hypercholesterolemia in patients with established CAD. Patients were interviewed 6–18 months after hospitalization for an acute coronary syndrome (ACS) or a myocardial revascularization procedure. Statins were prescribed at discharge to 94.4% of patients, while 68.1% of the patients hospitalized for an ACS were prescribed a high-dose statin. Hospitalization in a teaching hospital, percutaneous coronary intervention, cholesterol measurement during hospitalization and the male sex were related to prescription of statins at discharge. The intensity of lipid-lowering therapy in the post-discharge period increased in 17.3%, decreased in 11.7%, and did not change in 71.0% of the patients. The prescription of a lipid-lowering drug (LLD) at discharge (odds ratio 5.88 [95% confidence intervals 3.05–11.34]) and a consultation with a cardiologist (2.48 [1.51–4.08]) were related to the use of LLDs, while age (1.32 [1.10–1.59] per 10 years), loneliness (0.42 [0.19–0.94]), professional activity (1.56 [1.13–2.16]), and diabetes (1.66 [1.27–2.16]) were related to achieving an LDL cholesterol goal 6–18 months after discharge. In conclusion, health-system-related factors are associated with the LLD utilization, whereas mainly patient-related factors are related to the control of hypercholesterolemia following hospitalization for CAD.

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Section: Introductionmentioning

confidence: 99%

Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey

Jankowski

Kozieł

Setny³

et al. 2021

JCM

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“…High-risk ACS patients on this new pathway with LDL-C>190 mg/dL or statin intolerance, patients with LDL-C>100 mg/dL if already established on statin therapy, Lp(a) > 150 nmol/L, age<45 years were discharged on high dose statins and ezetimibe and were followed up in outpatient rehab clinic within two months [ 13 ]. The Euroaspire V study approach was different as patients in this pathway were followed by cardiologists and general practitioners [ 14 ]. They initiated this pathway to ensure that patients commenced lipid-lowering therapy during hospital admissions and had virtual cardiology clinic follow-ups in six weeks’ time.…”

Section: Reviewmentioning

confidence: 99%

“…These patients were referred to the hospital lipid clinic if LDL-C remained > 70 mg/dL for consideration of PCSK9 inhibitors. This significantly improved lipid control in patients and the percentage of patients achieving LDL-C < 70 mg/dL reached 64% in 2018 vs 30% in 2015 [ 3 , 13 , 14 ].…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of Lipid Management in Secondary Prevention and Comparison of International Lipid Management Pathways

Khan¹,

Gul²,

Yousif³

et al. 2023

Cureus

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Acute coronary syndrome remains a major cause of morbidity and mortality despite significant improvements in its prevention and management. Lipid management and other risk factors such as hypertension, diabetes, obesity, smoking and sedentary lifestyle stratification is the key to minimising this risk. Lipid management is an important part of secondary prevention and patients are historically undertreated after post-acute coronary syndrome. We performed a narrative review on observational studies on lipid management pathways post ACS on PubMed, Google Scholar, Journal Storage and ScienceDirect and excluded case reports, case series and randomized controlled trials. Our review showed that most patients following acute coronary syndrome receive suboptimal treatment for hypercholesterolemia. The role of statin in reducing future cardiac events risk is undisputable, however, statin intolerance remains a major concern. There is substantial variation in the management of lipids in patients following an acute cardiac event and patients were followed up in primary care in some countries and secondary care in others. The mortality risk is significantly high in patients with second or recurrent cardiac events and future cardiac events are associated with higher morbidity and mortality risk. There is significant variation in lipid management pathways in patients who suffer from cardiac events across the globe and lipid therapy optimization remains suboptimal in these patients, putting them at future risk of cardiovascular events. It is therefore imperative to optimally manage dyslipidemia in these patients in order to minimize the risk of subsequent cardiac events. Cardiac rehabilitation programs might be a way forward to incorporate lipid management for patients discharged from the hospital after having acute coronary events for lipid therapy optimization.

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“…Considering the disappointing results in secondary prevention, we conducted a randomized pilot study to evaluate whether an intensive mHealth lipid-lowering intervention implemented after a hospitalization due to IHD was associated with a lower LDLc level. We demonstrated that this strategy was associated with improved management of LDLc levels compared with standard care alone ( 11 ). Our current study aimed to assess whether this same structured mHealth-based protocol helped improve LDLc levels after a hospitalization due to IHD in a real-life population.…”

Section: Introductionmentioning

confidence: 98%

An intensive, structured, mobile devices-based healthcare intervention to optimize the lipid-lowering therapy improves lipid control after an acute coronary syndrome

Ruíz-Bustillo

Badosa

Cabrera-Aguilera

et al. 2022

Front. Cardiovasc. Med.

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AimsDespite the evidence, lipid-lowering treatment (LLT) in secondary prevention remains insufficient, and a low percentage of patients achieve the recommended LDL cholesterol (LDLc) levels by the guidelines. We aimed to evaluate the efficacy of an intensive, mobile devices-based healthcare lipid-lowering intervention after hospital discharge in patients hospitalized for acute coronary syndrome (ACS).Methods and resultsAmbiespective register in which a mobile devices-based healthcare intervention including periodic follow-up, serial lipid level controls, and optimization of lipid-lowering therapy, if appropriate, was assessed in terms of serum lipid-level control at 12 weeks after discharge. A total of 497 patients, of which 462 (93%) correctly adhered to the optimization protocol, were included in the analysis. At the end of the optimization period, 327 (70.7%) patients had LDLc levels ≤ 70 mg/dL. 40% of patients in the LDLc ≤ 70 mg/dL group were upgraded to very-high intensity lipid-lowering ability therapy vs. 60.7% in the LDLc > 70 mg/dL group, p < 0.001. Overall, 38.5% of patients had at least a change in their LLT. Side effects were relatively infrequent (10.7%). At 1-year follow-up, LDLc levels were measured by the primary care physician in 342 (68.8%) of the whole cohort of 497 patients. In this group, 71.1% of patients had LDLc levels ≤ 70 mg/dL.ConclusionAn intensive, structured, mobile devices-based healthcare intervention after an ACS is associated with more than 70% of patients reaching the LDLc levels recommended by the clinical guidelines. In patients with LDLc measured at 1-year follow-up, 71.1% had LDLc levels ≤ 70 mg/dL.

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Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial

Cited by 11 publications

References 26 publications

Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey

Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey

A Systematic Review of Lipid Management in Secondary Prevention and Comparison of International Lipid Management Pathways

An intensive, structured, mobile devices-based healthcare intervention to optimize the lipid-lowering therapy improves lipid control after an acute coronary syndrome

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