A secondary prevention program with nursing telephone follow-up for ACS patients achieved LDL-C targets in 54% at 4-6 weeks, with an 18.1% event rate over 1 year.
Observational (n=88)
No
Does a secondary prevention program with telephone follow-up conducted by nursing staff improve cardiovascular risk factor targets in patients discharged after ACS who are not enrolled in cardiac rehabilitation programs?
A nursing-led telephone follow-up program for secondary prevention in post-ACS patients not enrolled in cardiac rehabilitation achieved favorable cardiovascular risk factor control.
Abstract Introduction and Objectives Following an acute coronary syndrome (ACS), cardiac rehabilitation programs (CRPs) have been established as an effective strategy to improve cardiovascular outcomes. However, a significant proportion of patients do not participate in these programs, and conventional follow-up has proven insufficient in achieving cardiovascular risk factor (CVRF) targets. Objective To evaluate the effectiveness of a secondary prevention program with telephone follow-up conducted by nursing staff in patients discharged after ACS who are not enrolled in CRPs. Methods A prospective, descriptive, single-center observational study was conducted between September 2023 and December 2024. Clinical and laboratory variables were collected at discharge, at 4–6 weeks, and at 1 year after the event. Therapeutic adjustments were made during follow-up when required. Achievement of LDL-C, non-HDL-C, and glycated hemoglobin (HbA1c) targets was assessed according to current clinical practice guidelines. In addition, eligibility for prolonged dual antiplatelet therapy was evaluated using PEGASUS criteria. Results N=88; mean age 78 ± 8 years; 38% women. Smoking/ex-smoking: 47%; type 2 diabetes: 51%; hypertension: 74%; dyslipidemia: 67%. Chronic kidney disease: 24%; peripheral arterial disease: 7%; prior stroke: 12%; previous cardiovascular event: 32% (25% 2 years). NSTEMI: 73%; STEMI: 22%; unstable angina: 5%. Preserved LVEF in 78%. Laboratory characteristics at discharge are presented in Table 1. Follow-up was completed for 88 patients at 4–6 weeks and for 44 patients at 1 year. Achievement of LDL-C targets was 54% at 4–6 weeks, remaining stable at 1 year (4–6 weeks: 61.2 ± 30 mg/dL; 1 year: 61 ± 32 mg/dL). Non-HDL-C control: 58% at 4–6 weeks and 70% at 1 year (4–6 weeks: 85 ± 36 mg/dL; 1 year: 79 ± 41 mg/dL). HbA1c control: 62% at 4–6 weeks and 68% at 1 year (6.9 ± 1.5% at 4–6 weeks; 6.6 ± 1.1% at 1 year). Fifty percent of patients were candidates for prolonged dual antiplatelet therapy. During follow-up, 16 events (18.1%) occurred: 7 non-fatal MIs, 2 revascularizations, and 7 non-cardiovascular deaths. Treatment was modified in 30% of the cohort. Conclusions The study population was elderly, with multiple comorbidities, a high rate of recurrent events, and consequently substantial polypharmacy. These factors likely contributed to the limitations in extending dual antiplatelet therapy and in achieving treatment targets. Nevertheless, our results are more favorable than those reported in the literature regarding cardiovascular risk factor control in secondary prevention programs.
Vaca et al. (Mon,) conducted a observational in Acute coronary syndrome (n=88). Secondary prevention program with telephone follow-up by nursing staff was evaluated on Achievement of LDL-C targets at 4-6 weeks. A secondary prevention program with nursing telephone follow-up for ACS patients achieved LDL-C targets in 54% at 4-6 weeks, with an 18.1% event rate over 1 year.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: