Ariel Cohen1, Patrick Assyag2, Louise Boyer-Chatenet1, Alain Cohen-Solal3, Christel Perdrix4, Marie Dalichampt5, Pierre-Louis Michel6, Gilles Montalescot6, Philippe Ravaud7, P Gabriel Steg8, Isabelle Boutron7. 1. Service de Cardiologie, Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France. 2. currently in private practice, Paris, France. 3. Service de Cardiologie, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale Unité 738, Paris, France. 4. Service de Cardiologie, Hôpital La Roseraie, Aubervilliers, France. 5. Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France. 6. Institut Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Université Paris 6 (Université Pierre et Marie Curie), Institut National de la Santé et de la Récherche Médicale Commission Médicale Régionale 937, Paris, France. 7. Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France7Institut National de la Santé et de la Recherche Médicale Unité 738, Paris, France8Faculté de Médecine, Université Paris Descartes, Sorbonne Pari. 8. Département Hospitalo-Universitaire Fibrosis-Inflammation-Remodeling (FIRE), Hôpital Bichat, Assistance Publique des Hôpitaux de Paris, Paris, France10Service de Cardiologie, Institut National de la Santé et de la Recherche Médicale INSERM Unité 698, Univ.
Abstract
IMPORTANCE: Lifestyle improvements after an acute coronary syndrome reduce cardiovascular risk but are difficult to achieve. OBJECTIVE: To determine whether a nurse-led or dietician-led cardiovascular risk factor education program would improve risk factor reduction over the long term after an acute coronary syndrome. DESIGN, SETTING, AND PARTICIPANTS: The Réseau Insuffisance Cardiaque (RESICARD) PREVENTION: study was a 2-arm, parallel-group, multicenter, randomized clinical trial at 6 tertiary care hospitals in France. Patients hospitalized in a cardiac intensive care unit for an acute coronary syndrome with at least 1 lifestyle risk factor (current smoking, sedentary lifestyle, or overweight or obesity) were randomized according to a computer-generated list with sequentially numbered, sealed envelopes. INTERVENTION: Patients underwent an education program in a unique non-hospital setting (a House of Education) or were treated according to physicians' usual standard of care. MAIN OUTCOMES AND MEASURES: The primary outcome was a composite that included at least 1 of the following: smoking cessation, at least 3 hours per week of physical activity, at least 5% reduction in weight, and at least 4% reduction in waist circumference. Patients were followed up for 1 year. An intent-to-treat analysis was performed. RESULTS From June 21, 2006, to July 30, 2008, a total of 251 patients were randomized to the House of Education and 251 to conventional care. The 2 groups did not differ significantly at 12 months in the primary composite outcome (51.8% vs 49.8% success rate; adjusted relative risk [aRR], 1.11; 95% CI, 0.90-1.37) or with correction of all risk factors (aRR, 1.22; 95% CI, 0.89-1.66). Similarly, the 2 groups did not differ by physical activity (aRR, 1.05; 95% CI, 0.92-1.21), smoking cessation (aRR, 0.99; 95% CI, 0.87-1.13), and weight or waist reduction (aRR, 1.07; 95% CI, 0.84-1.36). CONCLUSIONS AND RELEVANCE: Compared with conventional care, the House of Education did not result in superior improvement in lifestyle-related cardiovascular risk factors after an acute coronary syndrome. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00337480.
RCT Entities:
IMPORTANCE: Lifestyle improvements after an acute coronary syndrome reduce cardiovascular risk but are difficult to achieve. OBJECTIVE: To determine whether a nurse-led or dietician-led cardiovascular risk factor education program would improve risk factor reduction over the long term after an acute coronary syndrome. DESIGN, SETTING, AND PARTICIPANTS: The Réseau Insuffisance Cardiaque (RESICARD) PREVENTION: study was a 2-arm, parallel-group, multicenter, randomized clinical trial at 6 tertiary care hospitals in France. Patients hospitalized in a cardiac intensive care unit for an acute coronary syndrome with at least 1 lifestyle risk factor (current smoking, sedentary lifestyle, or overweight or obesity) were randomized according to a computer-generated list with sequentially numbered, sealed envelopes. INTERVENTION: Patients underwent an education program in a unique non-hospital setting (a House of Education) or were treated according to physicians' usual standard of care. MAIN OUTCOMES AND MEASURES: The primary outcome was a composite that included at least 1 of the following: smoking cessation, at least 3 hours per week of physical activity, at least 5% reduction in weight, and at least 4% reduction in waist circumference. Patients were followed up for 1 year. An intent-to-treat analysis was performed. RESULTS From June 21, 2006, to July 30, 2008, a total of 251 patients were randomized to the House of Education and 251 to conventional care. The 2 groups did not differ significantly at 12 months in the primary composite outcome (51.8% vs 49.8% success rate; adjusted relative risk [aRR], 1.11; 95% CI, 0.90-1.37) or with correction of all risk factors (aRR, 1.22; 95% CI, 0.89-1.66). Similarly, the 2 groups did not differ by physical activity (aRR, 1.05; 95% CI, 0.92-1.21), smoking cessation (aRR, 0.99; 95% CI, 0.87-1.13), and weight or waist reduction (aRR, 1.07; 95% CI, 0.84-1.36). CONCLUSIONS AND RELEVANCE: Compared with conventional care, the House of Education did not result in superior improvement in lifestyle-related cardiovascular risk factors after an acute coronary syndrome. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00337480.
Authors: LaPrincess C Brewer; Brian Kaihoi; Kathleen K Zarling; Ray W Squires; Randal Thomas; Stephen Kopecky Journal: JMIR Res Protoc Date: 2015-04-08
Authors: Yu-Mi Lee; Rock Bum Kim; Hey Jean Lee; Keonyeop Kim; Min-Ho Shin; Hyeung-Keun Park; Soon-Ki Ahn; So Young Kim; Young-Hoon Lee; Byoung-Gwon Kim; Heeyoung Lee; Won Kyung Lee; Kun Sei Lee; Mi-Ji Kim; Ki-Soo Park Journal: Health Qual Life Outcomes Date: 2018-05-22 Impact factor: 3.186
Authors: Nader N Kabboul; George Tomlinson; Troy A Francis; Sherry L Grace; Gabriela Chaves; Valeria Rac; Tamara Daou-Kabboul; Joanna M Bielecki; David A Alter; Murray Krahn Journal: J Clin Med Date: 2018-12-04 Impact factor: 4.241