Randomized controlled trial comparing the efficacy of daily and every other day atorvastatin therapy and its correlation with serum hydroxymethylglutaryl-CoA reductase enzyme levels in naïve dyslipidemic patients

The development and randomised feasibility trial of a Nurse-led lifestyle modification follow-up programme among post-myocardial infarction patients

Background

Cardiovascular disease is the most often occurring disease in India accounting for 24.8% of deaths. Myocardial infarction contributes to this. A higher risk of cardiovascular disease exists due to comorbidities or the unawareness of existing illness among the Indian population. There is a shortage of published research on cardiovascular disease and a lack of standard cardiac rehabilitation programmes in India.

Aim

Our study aims to develop a Nurse-led lifestyle modification follow-up programme, to assess and compare the effectiveness of the programme on health outcomes and quality of life among post-myocardial infarction patients.

Methods

A two arm, single-blinded, randomised feasibility trial was conducted by developing a Nurse-led lifestyle modification follow-up programme. The interventional programme was based on the information-motivation-behavioural skill model and included health education, an educational booklet, and telephone follow-up. For feasibility testing of intervention, 12 patients were randomly allocated (n = 6/group). Patients in the control group were provided with routine care, while the intervention group was given routine care along with a Nurse-led lifestyle modification follow-up programme.

Results

It was possible to use this tool. In addition to determining the tool's feasibility for use we found that the intervention group showed a significant improvement in systolic blood pressure (BP) (p = 0.001), diastolic BP (p = 0.016), Body Mass Index (BMI) (p = 0.004), and quality of life in all the subscales - physical, emotional and social (p < 0.001) after 12 weeks of discharge.

Conclusion

Findings from this study will help to reinforce designing a cost-effective care delivery system in the care of post-myocardial infarction patients. This programme is a novel approach to improve preventive, curative and rehabilitative services for the post-myocardial infarction patients in India.

Atorvastatin combined with routine therapy on HIF-1, VEGF concentration and cardiac function in rats with acute myocardial infarction

Effect of atorvastatin combined with routine therapy on the expression of hypoxia inducible factor (HIF-1) and vascular endothelial growth factor (VEGF) in rats with acute myocardial infarction (AMI) and its therapeutic effect were investigated. The rat models of acute myocardial infarction were established and divided into routine therapy, study, model, single drug and control group according to the treatment plan, with 10 cases in each group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentration of HIF-1 and VEGF in serum of rats before treatment (T0), and 3 days (T1), 5 days (T2) and 7 days (T3) after treatment, and the cardiac function was measured at the same time. The concentrations of HIF-1 and VEGF in serum of the study group and the routine therapy group after treatment were significantly higher than those before treatment. The concentrations of HIF-1 and VEGF in serum of model group at T0 were significantly lower than those at T3 (P<0.05). After treatment, the concentrations of HIF-1 and VEGF in serum of the study group were significantly higher than those of the routine therapy, the model and the control group (P<0.05). One week after administration, there were significant differences in the left ventricular function among the five groups (P<0.001). The left ventricular function in the study group was better than that in the routine therapy, model and control group. The levels of HIF-1 and VEGF in the serum of rats with myocardial infarction were negatively correlated with LVIDs and LVIDd, and positively correlated with LVEF% and LVFS%. In conclusion, atorvastatin combined with routine therapy can better reduce serum HIF-1 and VEGF levels and improve the left ventricular function in rats than routine therapy.