A nurse-led lipid-lowering intervention significantly increased the achievement of LDL cholesterol ≤100 mg/dL at 6 months compared to standard care (97% vs 67%, P<0.001).
RCT
Does a nurse-led intensive lipid-lowering intervention improve LDL cholesterol control at six months in patients hospitalized for ischemic heart disease?
A nurse-led post-discharge follow-up intervention significantly improves the achievement of guideline-recommended LDL cholesterol targets in patients with ischemic heart disease.
Absolute Event Rate: 97% vs 67%
p-value: p=<0.001
BACKGROUND AND AIMS: Lack of achievement of secondary prevention objectives in patients with ischaemic heart disease remains an unmet need in this patient population. We aimed at evaluating the six-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an ischaemic heart disease event. METHODS: Randomized controlled trial, in which a nurse-led intervention including periodic follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, if appropriate, was compared with standard of care alone in terms of serum lipid-level control at six months after discharge. RESULTS: The nurse-led intervention was associated with an improved management of low-density lipoprotein (LDL) cholesterol levels compared with standard of care alone: LDL cholesterol levels ⩽100 mg/dL were achieved in 97% participants in the intervention arm as compared with 67% in the usual care arm ( p value <0.001), the LDL cholesterol ⩽70 mg/dL target recommended by the 2016 European Society of Cardiology guidelines was achieved in 62% vs. 37% participants ( p value 0.047) and the LDL cholesterol reduction of ⩾50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% of participants in the intervention arm as compared with 2.6% in the usual care arm ( p value 0.007). The intervention was also associated with improved blood pressure control among individuals with hypertension. CONCLUSIONS: Our findings highlight the opportunity that nurse-led, intensive, post-discharge follow-up plans may represent for achieving LDL cholesterol guideline-recommended management objectives in patients with ischaemic heart disease. These findings should be replicated in larger cohorts.
Ruiz et al. (2019) conducted an RCT in Ischemic heart disease. Nurse-led lipid-lowering secondary prevention intervention vs. Standard of care was evaluated on Achievement of LDL cholesterol ⩽100 mg/dL at 6 months (p=<0.001). A nurse-led lipid-lowering intervention significantly increased the achievement of LDL cholesterol ≤100 mg/dL at 6 months compared to standard care (97% vs 67%, P<0.001).