Importancia del seguimiento de pacientes con cardiopatía isquémica en tratamiento con atorvastatina como prevención secundaria: Estudio piloto

Objective: To determine the usefulness of different intensities of follow up when atorvastatin is used in the secondary prevention of ischemic heart disease. Material and methods: Design. Prospective study with balanced randomized allocation including a concurrent control group. Setting: Ambulatory care. Patients: 75 patients hospitalized because of acute coronary syndromes were administered atorvastatin as secondary prevention of ischemic heart disease and randomized either to intensive folow up or to a control visit 6 months apart. Interventions: The intensive folow up group (40 patients) was controlled every 2 months as outpatients and a physical examen and lipid profile was done, enhancing diet and exercise and adjusting the statin dose. The control group was evaluated just once after a 6 six month period. Results: 88% were males and the average age was 63.7 ′10 year. Basal characteristics, myocardial infarction, revascularized procedures and initial chemistry and lipid profile were similar in both groups, although there was a higher proportion of patients in the control group taking ACE. After 6 months total cholesterol, LDL colesterol and triglycerides reduction was higher in the intensive follow up group (33 vs. 24, 34 vs. 26 y 51 vs. 24 mg/dl, respectively) without realising statistical significance. Hospital readmissions were lesser in the intensive group (7.3% vs. 19.4%, P = 0.114). There was one death in each group. Conclusions: Results show a tendency indicating that follow up planification is relevant to obtein the target lipid level recomended in the secondary prevention.