Effects of intensive nursing care intervention outside hospital in patients with acute ST-segment elevation myocardial infarction undergoing emergency interventional therapy

Abstract

Objective: To observe the efficacy of multifactor intensive nursing intervention (telephone consultation, setting up outpatient nurses for coronary heart disease, health education, psychological care and guiding cardiac rehabilitation) in patients with acute ST-segment elevation myocardial infarction (STEMI) . Methods: We conducted an open-label, randomized and controlled trial at the 5th Affiliated Hospital of Sun Yat-Sen University. A total of 1920 patients with STEMI undergoing emergency interventional therapy were recruited and randomly divided into control group receiving usual care or intervention group receiving intensive nursing care. The patients (1874 cases) completed the follow-up of 24 months and the self-management abilities and clinical outcomes were reviewed. Results: Compared with usual-care group, intensive intervention group had better heart function and self-management abilities, including regular rehabilitation exercise, smoking cessation ratio, lipid success rate and self monitoring of blood sugar and blood pressure (P<0.001) . The use of secondary prevention drugs for CVD (statins, angiotensin-converting enzyme inhibitors, β-blockers and angiotensin II receptor antagonists) in intensive nursing group was higher than the usual-care group (P<0.001) , while the level of NT-pro-BNP, mortality and rehospitalization rates in intensive intervention group were lower than those of the usual-care group (P<0.05) . Conclusions: Multifactor intensive nursing care intervention is a good nursing care measure. It can help improve the self-management abilities and clinical outcomes for STEMI patients undergoing emergency interventional therapy. Key words: Acute myocardial infarction; Nursing case intervention; Randomized controlled trial