Management in Patients with Coronary Atherosclerotic Heart Disease Complicated with Chronic Heart Failure: A Community-based Study

Abstract

Background: Disease management programs (DMPs) are developed to address the high mortality, hospitalizations and costs of chronic diseases. DMPs are enforced on cardiovascular disease generally, such as hypertension, coronary atherosclerotic heart disease, chronic heart failure, and so on. This study is aimed to assess the effect on the management of patients suffering from coronary atherosclerotic heart disease complicated with chronic heart failure. Method: 823 community subjects who discharged from our department agreed to follow up and were enrolled randomly. They were ranked as the intensive management group and the control group. Patients in the intensive management group accepted standardized management out of hospital, regular health education, and were followed up in the form of telephone and outpatient visit. Result: Compared with the control group, patients in the intensive management group experienced a lower rate of all cause death, cardiovascular death and readmission due to cardiovascular events (CVE), declined by 26.5%, 32.2% and 57.0% respectively. All cause death, cardiovascular death and readmission due to CVE in the intensive management group had significantly negative correlation (r=-0.967, P<0.05) with the years of management. Over the four years period, the survival rate of the intensive management group was 0.92, 0.85, 0.83, and 0.82 per year respectively, while that of the control group was 0.95, 0.89, 0.82, and 0.75. Conclusion: Through standardized management out of hospital, patients with CHF due to CHD got significant benefit in reducing the rate of all cause death, cardiovascular death and readmission due to CVE, and improving survival rate.