Investigation of Motivational Interviewing and Prevention Consults to Achieve Cardiovascular Targets (IMPACT) trial

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From: American Heart Journal(Vol. 199)
Publisher: Elsevier B.V.
Document Type: Report
Length: 522 words

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To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ahj.2017.12.019 Byline: Eugenia Gianos, MD [Eugenia.Gianos@nyumc.org] (a,*), Antoinette Schoenthaler, EdD, MA (c), Yu Guo, MA (c), Judy Zhong, PhD (c), Howard Weintraub, MD (a), Arthur Schwartzbard, MD (a), James Underberg, MD (a), Michael Schloss, MD (a), Jonathan D. Newman, MD, MPH (a), Sean Heffron, MD, MS (a,b), Edward A. Fisher, MD, PhD (a,b), Jeffrey S. Berger, MD, MS (a,b) Abstract Background Patients undergoing cardiovascular (CV) procedures often have suboptimal CV risk factor control and may benefit from strategies targeting healthy lifestyle behaviors and education. Implementation of prevention strategies may be particularly effective at this point of heightened motivation. Methods A prospective, randomized, pilot study was conducted in 400 patients undergoing a nonurgent CV procedure (cardiac catheterization [plus or minus] revascularization) to evaluate the impact of different prevention strategies. Patients were randomized in a 1:1:1 fashion to usual care (UC; group A, n = 134), in-hospital CV prevention consult (PC; group B, n = 130), or PC plus behavioral intervention program (telephone-based motivational interviewing and optional tailored text messages) (group C, n = 133). The primary end point was the [DELTA] change in non--high-density lipoprotein cholesterol (non--HDL-C) from baseline to 6 month. Results The mean age was 64.6 [plus or minus] 10.8 years, 23.7% were female, and 31.5% were nonwhite. After 6 months, the absolute difference in non--HDL-C for all participants was -19.8 mg/dL (95% CI -24.1 to -15.6, P Conclusions Although non--HDL-C reduction at 6 months following a nonurgent CV procedure was not significant in the overall cohort, an increased uptake in high-potency statins may translate into improved long-term health outcomes and cost reductions. Author Affiliation: (a) Department of Medicine, Division of Cardiology, Center for the Prevention of Cardiovascular Disease, New York University School of Medicine, New York, NY (b) Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine, New York, NY (c) Department of Population Health, Center for Healthful Behavioral Change, New York University School of Medicine, New York, NY * Reprint requests: Eugenia Gianos, MD, Associate Professor of Medicine, Co-Clinical Director, Center for the Prevention of Cardiovascular Disease, Director, Preventive Cardiology Fellowship, 530 First Ave Schwartz HCC 4F, New York University Langone Medical Center, New York, NY 10016. Article History: Received 10 August 2017; Accepted 29 December 2017 (footnote) Vera Bittner, MD, MSPH, served as guest editor for this article. (footnote) Relationship with industry: none. (footnote) Clinical Trial Unique Identifier: NCT01642355.

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Gale Document Number: GALE|A538203054