SPC365

Enhancing Cardiovascular Health Post-Acute Coronary Syndrome: A Specialized Follow-up Program

Session: Sessão de Posters 22 - Risco cardiovascular
Speaker: Marta Leite

Congress: CPC 2024
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.14 Risk Factors and Prevention - Other
Session Type: Cartazes
FP Number: ---
Authors: Marta Leite; Maksym Baburko; Eduardo Vilela; Sílvia O. Diaz; António Barros; Francisca Saraiva; Ricardo Fontes-Carvalho
<p style="text-align:justify"><strong><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Background:</span></span></strong></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">In the domain of cardiovascular (CV) health, where Acute Coronary Syndrome (ACS) significantly influences morbidity and mortality, addressing the multifaceted challenges posed by this critical cardiac event demands tailored care strategies. </span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">This study investigates the comprehensive impact of a Structured Coronary-Disease Cardiology Consultation (SCCC) program on secondary prevention and CV risk factor control in the first year following an ACS.</span></span></p>

<p style="text-align:justify"><strong><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Methods:</span></span></strong></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">A retrospective analysis scrutinized outcomes in two distinct patient cohorts: the SCCC group as the intervention group (August 2021 to July 2022) and the Regular Cardiology Consultation (RCC) group as the control group (January to December 2018). Over a 12-month observation period post-ACS, parameters such as lipid profiles, specifically low-density lipoprotein-cholesterol (LDL-C) levels, glycated hemoglobin (HbA1c), systolic blood pressure (SBP), and smoking habits were assessed. The intervention effectiveness was confirmed through an analysis of covariance (ANCOVA). </span></span></p>

<p style="text-align:justify"><strong><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Results:</span></span></strong></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Our study included 521 patients, 284 in the RCC group and 237 in the SCCC group. Baseline characteristics were comparable between the groups.</span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">The SCCC group exhibited lower LDL-C values at the end of the follow-up compared to the RCC group [RCC group: 66 (53, 84) mg/dL vs. SCCC group: 52 (43, 66) mg/dL, p&lt;0.001], a significant reduction in HbA1C among diabetic patients [RCC group: 7.00% (6.30, 7.80) vs. SCCC group: 6.40% (6.10, 6.85), p=0.007], and no significant differences in SBP [RCC group: 130 (120, 141) mmHg vs. SCCC group: 130 (117, 140) mmHg, p=0.2].</span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Though not statistically different between the SCCC and RCC groups (p=0.14), nearly two-thirds of active smokers quit in the first year post-ACS in the SCCC group, underlying the positive influence of cardiology consultation programs on smoking behaviors.</span></span></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">According to our ANCOVA analysis (Table 1), the SCCC group exhibited a marked and statistically significant decrease in low-density lipoprotein cholesterol (LDL-C) levels [&beta; = -13 (-19, -7.4), p&lt;0.001], with almost two-thirds of diabetic patients achieving and maintaining the established HbA1c goals [&beta; = -0.46 (-0.87, -0.05), p=0.029], and a statistically significant reduction in SBP was also observed in the SCCC group [&beta; = -3.7 (-6.5, -0.84), p = 0.011].</span></span></p>

<p style="text-align:justify"><strong><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Conclusions:</span></span></strong></p>

<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Verdana,Geneva,sans-serif">Implementing an SCCC program emerges as a multifaceted intervention leading to lower median values for LDL-C, improved glycemic control, reduced blood pressure, and successful smoking cessation one year after ACS. The multidisciplinary approach and standardized monitoring of CV risk factors contributed to these positive results, underscoring the importance of structured follow-up protocols in managing CV risk factors after acute coronary events.</span></span></p>