Abstract
Changes in lifestyle include a healthy diet. However, due to different educational approaches, the effects of nutritional counselling are still not very encouraging and require further study. The objective of this study was to analyse the effectiveness of a nutrition education intervention program on mortality and recurrence of cardiovascular events evaluated after one and four years of follow-up. A randomized clinical trial was performed at a public hospital in Brazil with 200 patients who had recently undergone elective percutaneous coronary intervention (PCI). In addition to the traditional care, the patients allocated to the intervention group attended nutrition education workshops that adopted a constructivist approach towards behavioural change for six months. Primary outcome was death, and secondary outcomes were acute myocardial infarction (AMI), revascularization with re-PCI, or coronary artery bypass graft (CABG) surgery. The magnitude of the first year effect was calculated by the absolute risk reduction, and the risk ratio was calculated as a measure of the cumulative incidence of events after four years. The critical p-value was assumed as 5%. After one year of follow-up, in the intervention and control groups, respectively, there were 5 and 7 deaths (p = 0.53); 5 and 6 AMIs (p = 0.73); 4 and 6 re-PCIs (p = 0.50); and 4 and 4 CABGs (p = 0.98). After four years, the risk ratios between intervention and control groups were 0.75 (95% CI 0.35–1.58) for death, 0.89 (95% CI 0.34–2.28) for AMI, 0.86 (95% CI 0.40–1.84) for re-PCI, and 1.14 (95% CI 0.38–3.40) for CABG. Although differences in events between the two groups were not significant, data suggest that the lower number of events observed in the intervention group is most notable with the longer follow-up. NCT01028066 . Registered 8 December 2009, retrospectively registered.
Highlights
Changes in lifestyle include a healthy diet
The objective of this randomized trial was to analyse the effectiveness of a nutrition education intervention on mortality and the recurrence of cardiovascular events in patients who had previously undergone percutaneous coronary intervention (PCI)
The sample size was calculated based on the results from Lisspers et al [5], who assessed the recurrence of cardiovascular mortality, acute myocardial infarction (AMI), coronary artery bypass graft (CABG), or re-PCI in chronic coronary patients after a PCI
Summary
Changes in lifestyle include a healthy diet. due to different educational approaches, the effects of nutritional counselling are still not very encouraging and require further study. The objective of this study was to analyse the effectiveness of a nutrition education intervention program on mortality and recurrence of cardiovascular events evaluated after one and four years of follow-up Changes in lifestyle, such as smoking cessation; regular physical activity; a diet rich in fruits, vegetables, whole grains, and fish; and a healthy weight can reduce the incidence of coronary heart disease by over 80% [1]. Cognitivebehavioural strategies are currently emerging as a key component in behavioural change interventions and are focused on changing how individuals think about themselves, their attitudes, and how they can change their lifestyle, using resources, such as concrete goals, feedback and positive reinforcement, and relapse prevention [9] The objective of this randomized trial was to analyse the effectiveness of a nutrition education intervention on mortality and the recurrence of cardiovascular events in patients who had previously undergone percutaneous coronary intervention (PCI)
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