Article

Elderly patients have been underrepresented in secondary
cardiovascular prevention programmes. This study aimed to ascertain the effects
of a secondary coronary disease prevention programme in these patients. Design
Open randomised intervention study with parallel groups. Methods One hundred and
twenty-seven patients aged >/=70 years with a recent acute coronary syndrome were
randomised to a protocolised clinical intervention plus usual care (intervention
group, n = 64) or to usual care alone (control group, n = 63). Patients were
assessed at baseline and after 12 months. The main outcome was the percentage of
patients with optimal risk factor control after 12 months of follow-up. Secondary
outcomes included changes in Mediterranean diet adherence, quality of life and
functionality. Mortality was evaluated three years after the end of the
intervention. Results One hundred and six patients (83.4%) completed 12 months of
follow-up (54 in the intervention group and 52 in the control group). At the end
of intervention, 34.2% more patients in the intervention group had achieved
optimal risk factor control with a number needed to treat of 3 (relative risk
2.18, 95% confidence interval 1.36 to 3.50). The intervention group improved
adherence to the Mediterranean diet ( p = 0.013) and functionality assessed by
the Short Physical Performance Battery ( p = 0.047).
No differences between
groups were found in quality of life (Short-Form 36 Health Survey) or mortality
after three years (hazard ratio 1.19, 95% confidence interval 0.41 to 3.45).
Conclusions A secondary coronary disease prevention programme in elderly patients
with a recent acute coronary syndrome improved risk factor control, Mediterranean
diet adherence and functionality.

Langue : ANGLAIS