P1229Intensive prevention program after myocardial infarction: how can LDL cholesterol be reduced and how long are intensive prevention efforts needed?

Background: Hypercholesterinaemia is a well-known risk factor in cardiovascular disease and guidelines recommend to lower LDL cholesterol levels in manifest coronary heart disease. Patient education leads to better drug compliance; however, until now prevention programs (such as EUROACTION or RESPONSE II) did not show significant effects on lipid levels. Purpose: Aim of the study was to prove the effects of a modern intensive prevention program (IPP) for 12 months after acute myocardial infarction (MI) on lipid levels in a longtime view. Methods: In the multicenter IPP trial patients with MI were randomized one month after discharge to IPP versus usual care (UC). IPP was coordinated by prevention assistants and included education sessions (≥1/month), telemetric risk factor control, telephone visits and clinical visits to control and intervene, if risk factors did not meet the guideline-recommended targets. To optimize risk factors patients, their general practitioners and cardiologists were requested both orally and in writing to escalate prevention efforts and medication. The primary endpoint of the IPP trial was global risk factor control at the end of the prevention program at 12 months, last follow up was performed after 24 months.