Evaluation of Secondary Prevention of Cardiac Disease by Nurse Specialists

Rationale: Treatments for secondary prevention of clinical events in patients with coronary artery disease are currently sub-optimally implemented. We hypothesize that a 6 month outpatient counselling and treatment course led by a nurse, in addition to usual care, reduces the risk of recurrent clinical events compared to usual care alone.

Objective:

Primary objective: To quantify the impact of outpatient nurse-led prevention clinics on the risk of future clinical events as calculated by the Copenhagen Risk score in patients with symptomatic coronary artery disease.

Study population: Patients aged 18-80 years who have been hospitalised less than 8 weeks before inclusion for an acute coronary syndrome.

Intervention: Intervention group is seen up to 4 times in 6 months following occurrence of acute coronary syndrome at a nurse-led outpatient clinic in addition to usual. Control group receives usual care only.

Main study parameters: The following parameters (and change herein) are compared at baseline, at 6 months and at 12 months after inclusion in study in both study groups:

1. Copenhagen Risk score

2. Smoking status

3. Exercise status

4. Body Mass Index

5. Waist circumference

6. Systolic blood pressure

7. Diastolic blood pressure

8. Diabetes status, fasting glucose, HbA1c levels

9. Total cholesterol, HDL, LDL, Triglycerides

A 6 month outpatient counselling and treatment course by a nurse (in addition to usual care) reduces the risk of recurrent clinical events compared to usual care alone

Baseline

follow-up 6 months

follow-up 12 months

Intervention group is seen up to 4 times in 6 months following occurrence of acute coronary syndrome at a nurse-led outpatient clinic in addition to usual care. The nurse-led outpatient clinic focuses on lifestyle, established cardiovascular risk factors and medication adherence.