Secondary prevention programme of ischaemic heart disease in the elderly: A randomised clinical trial

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. Open randomised intervention study with parallel groups. 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. 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). A secondary coronary disease prevention programme in elderly patients with a recent acute coronary syndrome improved risk factor control, Mediterranean diet adherence and functionality