What is the clinical evidence from this study?

Study design: Cohort. Population: Acute coronary syndrome (n=513). Intervention: Structured Coronary-Disease Follow-up Program (SCCC) vs. Routine Cardiology Consultation (RCC). Primary outcome: Change in LDL-C levels at 12 months (β -13, 95% CI -18, -8, p=<0.001).

December 5, 2025Open Access

Optimizing cardiovascular risk control after an acute coronary syndrome: the role of a structured follow-up program

Q: What are the key findings of this study?

A structured follow-up program after an acute coronary syndrome significantly improved cardiovascular risk factor control at 12 months, including a greater reduction in LDL-C (mean difference -13 mg/dL) compared to routine care.

Key Result

A structured follow-up program after an acute coronary syndrome significantly improved cardiovascular risk factor control at 12 months, including a greater reduction in LDL-C (mean difference -13 mg/dL) compared to routine care.

Study Design

Type

Cohort (n=513)

Multicenter

Structured PICO

Does a structured follow-up program improve cardiovascular risk factor control in patients after an acute coronary syndrome?

Population

513 patients with acute coronary syndrome (excluding type 2 MI) were evaluated in a retrospective cohort study comparing a structured 12-month follow-up program to historical routine care.

Exposure

Structured Coronary-Disease Follow-up Program (SCCC) including mandatory follow-up appointments with a cardiologist in the first 2 and 12 months, prespecified blood tests, transthoracic echocardiogram, and multidisciplinary care

Comparator

Regular Cardiology Consultation (RCC) historical control group receiving routine care without predefined schedules for consultations or cardiovascular risk factor assessment

Outcome

Low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c) in patients with diabetes mellitus, systolic blood pressure (SBP), and smoking cessation at 12 monthssurrogate

A structured, multidisciplinary follow-up program significantly improves the control of LDL-C, HbA1c, and systolic blood pressure at 12 months post-ACS compared to routine care.

Main Result

Mean Difference: -13 (95% CI -18–-8)

Absolute Event Rate: 62% vs 77%

p-value: p=<0.001

Limitations

Retrospective, population-based analysis rather than a randomized controlled trial
Use of a historical comparison cohort with a 4-year gap may introduce bias
Baseline differences in the prevalence of overweight/obesity and history of coronary artery disease between groups
Lower proportion of paired LDL-C and HbA1c measurements in the routine care group

Abstract

Effective secondary prevention after an acute coronary syndrome (ACS) remains a challenge, particularly in achieving optimal control of cardiovascular risk factors (CVRF). This study aimed to evaluate the impact of a Structured Coronary-Disease Follow-up Program (SCCC) on the management of key CVRFs 12 months after ACS. A comparative analysis was conducted between patients enrolled in the SCCC and a historical cohort receiving routine care (RCC). Primary outcomes included low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c) in patients with diabetes mellitus, systolic blood pressure (SBP), and smoking cessation at 12 months. Intragroup changes were assessed using paired Wilcoxon tests, while the program’s impact was evaluated through analysis of covariance (ANCOVA) and logistic regression. A total of 521 patients were included (237 SCCC, 284 RCC). In the SCCC group, significant reductions were observed in LDL-C [from 99 (interquartile range, IQR: 74-126) to 52 (IQR: 43-66) mg/dL, p0.9). In conclusion, implementation of a structured follow-up program after ACS was associated with improved control of LDL-C, HbA1c, and SBP, supporting the role of coordinated post-ACS care in enhancing CVRF management.

Mark Helpful

Bookmark

Relay

View Full Paper