Study Design

• Randomized

Patients Enrolled: 8,657
Mean Follow Up: 1 year

Patient Populations:

Acute coronary syndrome or stable coronary artery disease (coronary disease cohort) or at high risk for coronary artery disease or treated for hypertension of diabetes (high-risk cohort)

Exclusions:

• Severe heart failure
• Severe physical disability
• Dementia

Primary Endpoints:

Goals:
• No smoking
• Saturated fat <10% of total dietary energy per day, fruit and vegetables >400 g per day, fish >20 g per day, oily fish >3 times per week, and alcohol <30 g per day
• Body mass index <25 kg/m², waist circumference <80 cm for women and <94 cm for men
• Physical activity: 30-45 minutes of moderate intensity physical activity 4-5 times per week
• Blood pressure <140/90 mm Hg (<130/85 mm Hg for diabetics)
• Total cholesterol <5 mmol/L, low-density lipoprotein cholesterol <3 mmol/L
• Blood glucose concentration <6.1 mmol/L, glycated hemoglobin <7% for diabetics
• Cardioprotective medications prescribed as clinically indicated; antiplatelet medications, beta-blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering medications

Drug/Procedures Used:

Hospitals and general practices in eight countries were randomized to usual care (n = 2,613 patients and 1,634 partners) or EuroAction intervention program (n = 2,778 patients and 1,632 partners). In the intervention group, a nurse-led intervention team sought to improve lifestyle, risk factors, and therapeutic management. Lifestyle and risk factors addressed included diet, physical activity, central obesity, blood pressure, cholesterol, and glucose.

Concomitant Medications:

At the initial patient assessment, the use of antiplatelet drugs (for hospital coronary patients receiving intensive nursing intervention vs. hospital coronary patients receiving usual care) was 94% versus 95%, beta-blockers was 78% versus 85%, angiotensin-converting enzyme inhibitors was 55% versus 47%, and statins was 79% versus 79%.