Nurse-based secondary preventive follow-up by telephone reduced the composite of cardiovascular death, myocardial infarction, stroke, and cardiac revascularization by 19% (HR 0.81).
RCT (n=1,890)
Open-label
1:1
No
Does long-term, nurse-based secondary preventive follow-up by telephone reduce the recurrence of cardiovascular events in patients admitted to hospital due to stroke, TIA, or ACS?
Long-term nurse-based telephone follow-up significantly reduces the recurrence of cardiovascular events in patients with a history of stroke, TIA, or ACS compared to usual care.
Effect estimate: HR 0.81 (95% CI 0.68-0.97)
Absolute Event Rate: 22.7% vs 27.1%
p-value: p=0.02
Enhanced follow-up is needed to improve the results of secondary preventive care in patients with established cardiovascular disease. We examined the effect of long-term, nurse-based, secondary preventive follow-up by telephone on the recurrence of cardiovascular events. Open, randomised, controlled trial with two parallel groups. Between 1 January 2010 and 31 December 2014, consecutive patients (n = 1890) admitted to hospital due to stroke, transient ischaemic attack (TIA), or acute coronary syndrome (ACS) were included. Participants were randomised (1:1) to nurse-based telephone follow-up (intervention, n = 944) or usual care (control, n = 946) and followed until 31 December 2017. The primary endpoint was a composite of stroke, myocardial infarction, cardiac revascularisation, and cardiovascular death. The individual components of the primary endpoint, TIA, and all-cause mortality were analysed as secondary endpoints. The assessment of outcome events was blinded to study group assignment. After a mean follow-up of 4.5 years, 22.7% (n = 214) of patients in the intervention group and 27.1% (n = 256) in the control group reached the primary composite endpoint (HR 0.81, 95% CI 0.68-0.97; ARR 4.4%, 95% CI 0.5-8.3). Secondary endpoints did not differ significantly between groups. Nurse-based secondary preventive follow-up by telephone reduced the recurrence of cardiovascular events during long-term follow-up.
Irewall et al. (Mon,) conducted a rct in Stroke, transient ischemic attack (TIA), or acute coronary syndrome (ACS) (n=1,890). Nurse-based telephone follow-up vs. Usual care was evaluated on Composite of stroke, myocardial infarction, cardiac revascularisation, and cardiovascular death (HR 0.81, 95% CI 0.68-0.97, p=0.02). Nurse-based secondary preventive follow-up by telephone reduced the composite of cardiovascular death, myocardial infarction, stroke, and cardiac revascularization by 19% (HR 0.81).