Abstract
Structured secondary cardiovascular prevention programs (SSCP) following acute coronary syndromes (ACS) may reduce major adverse cardiovascular events (MACE) through better adherence to post-ACS recommendations. Through a prospective multicenter cohort study, we compared the outcomes of two sequential post-ACS patient cohorts, the initial one receiving standard care (SC) followed by one receiving additional interventions (SSCP) aimed at improving patient education as well as healthcare provider and hospital systems. The primary endpoint was MACE at one year. Secondary endpoints included adherence to recommended therapies, attendance to cardiac rehabilitation (CR) and successful achievement of cardiovascular risk factor (CVRF) targets. In total, 2498 post-ACS patients from 4 Swiss university hospitals were included: 1210 vs 1288 in the SC and SSCP groups, respectively. The SSCP group demonstrated a significant increase in attendance to CR programs (RR 1.08, 95%CI 1.02-1.14, P = 0.006), despite not achieving the primary MACE endpoint (HR 0.97, 95%CI 0.77-1.22, P = 0.79). After age-stratification, significant reductions in cardiac death, MI and stroke events (HR 0.53, 95%CI 0.30-0.93, P for interaction = 0.016) were observed for S...Continue Reading
References
Sep 4, 1999·American Journal of Public Health·R E GlasgowS M Boles
Mar 12, 2002·JAMA : the Journal of the American Medical Association·Rajendra H MehtaUNKNOWN GAP Steering Committee of the American College of Cardiology
Sep 3, 2002·Journal of the American College of Cardiology·Ira S OckeneJacqueline Dunbar-Jacob
Sep 24, 2004·Annals of Internal Medicine·Jason M LappéJeffrey L Anderson
Dec 24, 2004·European Heart Journal·Christian Juhl TerkelsenHenning Rud Andersen
Oct 4, 2005·Journal of the American College of Cardiology·Kim A EagleUNKNOWN American College of Cardiology Foundation (Bethesda, Maryland) Guidelines Applied in Practice Steering committee
Nov 3, 2005·Annals of Internal Medicine·Alexander M ClarkFinlay A McAlister
Mar 22, 2007·JAMA : the Journal of the American Medical Association·Ph Gabriel StegUNKNOWN REACH Registry Investigators
May 3, 2007·JAMA : the Journal of the American Medical Association·Keith A A FoxUNKNOWN GRACE Investigators
Jun 11, 2008·Circulation·Reto AuerWilliam A Ghali
Jun 17, 2008·Lancet·D A WoodUNKNOWN EUROACTION Study Group
Mar 17, 2009·Lancet·Kornelia KotsevaUNKNOWN EUROASPIRE Study Group
Apr 14, 2010·The Journal of Cardiovascular Nursing·Nancy Houston Miller
Oct 19, 2010·Health Research Policy and Systems·André Busato, Georg von Below
Aug 30, 2011·European Heart Journal·Christian W HammUNKNOWN ESC Committee for Practice Guidelines
May 5, 2012·European Heart Journal·Joep PerkUNKNOWN ESC Committee for Practice Guidelines (CPG)
Jun 6, 2012·JAMA : the Journal of the American Medical Association·Otávio BerwangerUNKNOWN Bridge-Acs Investigators
Jul 20, 2012·Circulation. Cardiovascular Quality and Outcomes·Anne Lambert-KerznerUNKNOWN Multifaceted Intervention to Improve Cardiac Medication Adherence and Secondary Prevention Measures (Medication) Study Inves
Aug 28, 2012·European Heart Journal·Kristian ThygesenUNKNOWN ESC Committee for Practice Guidelines (CPG)
Dec 20, 2012·Circulation·Quinn R PackSteven J Keteyian
Mar 29, 2014·PloS One·Reto AuerNicolas Rodondi
Jul 31, 2014·Journal of the American Heart Association·Sylvie S L Leung YinkoUNKNOWN GENESIS‐PRAXY investigators
Jan 15, 2015·European Journal of Internal Medicine·Baris GencerFrançois Mach
Jan 15, 2015·Atherosclerosis·Baris GencerNicolas Rodondi
Mar 22, 2015·Heart·Roland KlingenbergChristian M Matter
Apr 19, 2015·European Heart Journal·Han de VriesNiels Peek