Abstract 23240: Investigation of Motivational Interviewing and Prevention Consults to Achieve Cardiovascular Targets Trial
Background: Patients undergoing cardiovascular (CV) procedures often have suboptimal risk factor control and would benefit from strategies targeting healthy lifestyle behaviors and education. Implementation of prevention strategies may be timely at this point of heightened motivation.
Methods: A prospective randomized, controlled clinical trial was conducted in patients undergoing a non-urgent CV procedure to evaluate the impact of different prevention strategies on CV risk factors 6 months post-procedure. 400 patients were recruited at the time of a CV procedure between 5/12 and 8/15. Patients were randomized in a 1:1:1 fashion to usual care (Group A), in-hospital prevention consult (Group B), or in-hospital prevention consult plus behavioral intervention program [telephone-based motivational interviewing and tailored text messages] (Group C). The primary endpoint was non-HDL-cholesterol (non-HDL-C). Secondary endpoints included LDL-C, HDL-C, triglycerides, blood pressure (BP), HbA1c, body mass index, guideline-directed medical therapy, and validated measures of lifestyle and quality of life.
Results: The mean age was 64.6 ± 10.8 years, 23.7% were female and 31.5% were non-white. Overall, the absolute reduction in non-HDL was -20.7 mg/dl [95% CI (24.9,-16.5) p<0.001]. There were no between-group differences in the intervention and control arms (B and C vs A) with an absolute difference of -4.42 mg/dl, [95% CI (-12.7, 6.2) (p=0.29)]. However, patients in the intervention groups were more likely to be on high intensity statins at 6 months, (52.9% vs 38.1%, p=0.01). In contrast to men, women had a significant reduction in non-HDL with a prevention consult alone (group B vs A); absolute difference -22.73 mg/dl, [(95% CI (-43.95,-1.52), p=0.04]) and systolic BP reduction was greater in group C vs. A, -3.5 mmHg [95% CI (-9.63, -0.44) (p=0.03)].
Conclusions: At 6 months following a CV procedure, there was no between-group difference in the primary endpoint, other than in the subgroup of women. However, the greater use of high potency statins following a prevention consult could still translate into improved long-term health outcomes. Results of this trial will illustrate areas to target secondary prevention and areas where deficiencies remain.
Author Disclosures: E. Gianos: None. A. Schoenthaler: None. Y. Guo: None. H.S. Weintraub: Other Research Support; Modest; Amarin clinical trial, Sanofi clinical trial. Consultant/Advisory Board; Modest; Sanofi, Gilead. Consultant/Advisory Board; Significant; Amgen. A.Z. Schwartzbard: Other Research Support; Modest; Pfizer clinical trial. J.A. Underberg: Other Research Support; Modest; Aegerion, Genzyme, Pfizer. Speakers Bureau; Modest; Genzyme, Aegerion, Regeneron, AstraZeneca, Merck & Co. Inc. Speakers Bureau; Significant; Amgen, Alexion. Consultant/Advisory Board; Modest; Aegerion Pharmaceuticals, Amarin, Amgen, AstraZeneca, Eli Lilly & Co., Regeneron, Synageva, Recombine, Genzyme, Akeca, Kowa Pharmaceuticals, Alexion. Consultant/Advisory Board; Significant; Sanofi. J.D. Newman: None. E.A. Fisher: Speakers Bureau; Modest; Merck. J.S. Berger: None.
- © 2016 by American Heart Association, Inc.