Document Detail


Intensive surveillance and treatment of dyslipidemia in the postinfarct patient: evaluation of a nurse-oriented management approach.
MedLine Citation:
PMID:  11223487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lowering plasma low density lipoprotein (LDL) cholesterol concentrations in patients with established coronary artery disease is essential if recurrent cardiac events and mortality are to be prevented; however, a large proportion of patients with myocardial infarction (MI) are not screened and treated appropriately in the months immediately following hospital discharge. OBJECTIVES AND METHODS: The CHOlesterol Post-INfarct (CHOPIN) project is a nurse-centred program initiated to close the large gap between nationally centred recognized guidelines for LDL lowering and current actual practice in the secondary prevention of coronary artery disease. RESULTS: The authors report findings in 151 consecutive patients (70 years of age or less) followed for an average of 5.5+/-3.3 months. Three months after an index MI and at a time when patients started being followed in CHOPIN, 46% of patients had LDL in excess of 2.5 mmol/L and 36% had LDL greater than 3.20 mmol/L. LDL-lowering interventions undertaken comprised either consultation with a dietitian (35%) or initiation or modification of lipid-lowering medication (58%). Mean LDL on discharge from CHOPIN was 2.58+/-0.49 mmol/L, and 97% of the patients had LDL cholesterol less than 3.20 mmol/L at discharge. CONCLUSIONS: This experience shows that a nurse-based case management strategy can achieve good control of dyslipidemia in a large proportion of post-MI patients. Because intervention to lower LDL has been prospectively shown to reduce the need for coronary artery bypass and angioplasty, these results suggest that projects configured in the manner of CHOPIN should reduce hospital costs associated with cardiovascular disease.
Authors:
J P Baillargeon; S Lepage ; L Larrivée ; M A Roy; S Landry ; P Maheux
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  17     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-06     Completed Date:  2001-03-29     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  169-75     Citation Subset:  IM    
Affiliation:
Université de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec J1H 5N4, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antilipemic Agents / adverse effects*,  therapeutic use
Cholesterol, LDL / blood
Female
Humans
Hyperlipidemias / blood,  epidemiology,  etiology,  nursing*
Incidence
Male
Middle Aged
Myocardial Infarction / blood,  complications*,  drug therapy
Patient Compliance
Population Surveillance*
Prognosis
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antilipemic Agents; 0/Cholesterol, LDL

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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