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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.
Ruiz-Bustillo, Sonia; Ivern, Consol; Badosa, Neus; Farre, Nuria; Marco, Esther; Bruguera, Jordi; Cladellas, Mercè; Enjuanes, Cristina; Cainzos-Achirica, Miguel; Marti-Almor, Julio; Comin-Colet, Josep.
Afiliação
  • Ruiz-Bustillo S; 1 Department of Cardiology, Hospital del Mar, Barcelona, Spain.
  • Ivern C; 2 Departament of Medicine, Autonomous University of Barcelona, Spain.
  • Badosa N; 3 Biomedical Research Group (GREC), Hospital del Mar Biomedical Research Institute (IMIM), Barcelona, Spain.
  • Farre N; 1 Department of Cardiology, Hospital del Mar, Barcelona, Spain.
  • Marco E; 2 Departament of Medicine, Autonomous University of Barcelona, Spain.
  • Bruguera J; 3 Biomedical Research Group (GREC), Hospital del Mar Biomedical Research Institute (IMIM), Barcelona, Spain.
  • Cladellas M; 1 Department of Cardiology, Hospital del Mar, Barcelona, Spain.
  • Enjuanes C; 2 Departament of Medicine, Autonomous University of Barcelona, Spain.
  • Cainzos-Achirica M; 3 Biomedical Research Group (GREC), Hospital del Mar Biomedical Research Institute (IMIM), Barcelona, Spain.
  • Marti-Almor J; 1 Department of Cardiology, Hospital del Mar, Barcelona, Spain.
  • Comin-Colet J; 2 Departament of Medicine, Autonomous University of Barcelona, Spain.
Eur J Cardiovasc Nurs ; 18(5): 366-374, 2019 06.
Article em En | MEDLINE | ID: mdl-30757908
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Miocárdica / Papel do Profissional de Enfermagem / Prevenção Secundária / Hiperlipidemias / LDL-Colesterol / Anticolesterolemiantes Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Miocárdica / Papel do Profissional de Enfermagem / Prevenção Secundária / Hiperlipidemias / LDL-Colesterol / Anticolesterolemiantes Idioma: En Ano de publicação: 2019 Tipo de documento: Article