A nurse-led, telephone-based follow-up including medical titration significantly reduced mean LDL-C by 0.28 mmol/L compared to usual care at 36 months in patients with acute coronary syndrome.
RCT (n=962)
Open-label
Computer allocation in blocks of four, stratified by type of ACS and sex
No
Does a nurse-led, telephone-based follow-up with medical titration improve LDL-C and blood pressure in patients after acute coronary syndrome?
A nurse-led, telephone-based follow-up with medical titration significantly improves long-term blood pressure and LDL-C control in patients following acute coronary syndrome compared to usual care.
Effect estimate: Difference 0.28 mmol/L (95% CI 0.135-0.42)
Absolute Event Rate: 2.14% vs 2.42%
p-value: p=<0.001
We investigated whether a nurse-led, telephone-based follow-up including medical titration was superior to usual care in improving blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) values 36 months after acute coronary syndrome (ACS). We screened all patients admitted with ACS at Östersund hospital, Sweden, between January 1, 2010, and December 31, 2014, for inclusion based on ability to participate in a telephone-based follow-up. Participants were randomly allocated to usual care or an intervention group that received counselling and medical titration to target BP < 140/< 90 mmHg and LDL-C < 2.5/< 1.8 mmol/L. The primary outcome was LDL-C at 36 months. Of 962 patients, 797 (83%) were available for analysis after 36 months. Compared to controls, the intervention group had a mean systolic BP (SBP) 4.1 mmHg lower (95% confidence interval CI 1.9-6.5), mean diastolic BP (DBP) 2.9 mmHg lower (95% CI 1.5-4.5), and mean LDL-C 0.28 mmol/L lower (95% CI 0.135-0.42). All P < 0.001. A significantly greater proportion of patients reached treatment targets with the intervention. After 36 months of follow-up, compared to usual care, the nurse-led, telephone-based intervention led to significantly lower SBP, DBP, and LDL-C and to a larger proportion of patients meeting target values.Trial registration: ISRCTN registry. Trial number ISRCTN96595458. Retrospectively registered.
Henriksson et al. (Mon,) conducted a rct in Acute coronary syndrome (ACS) (n=962). Nurse-led, telephone-based follow-up and medical titration vs. Usual care was evaluated on Mean LDL-C at 36 months (Difference 0.28 mmol/L, 95% CI 0.135-0.42, p=<0.001). A nurse-led, telephone-based follow-up including medical titration significantly reduced mean LDL-C by 0.28 mmol/L compared to usual care at 36 months in patients with acute coronary syndrome.