None listed
Conditions
Brief summary
Patients referred to hospital chest pain clinics are often found to have non-cardiac (non threatening) symptoms, but have been found to have a high prevalence of risk factors (eg high cholesterol, smoking) for subsequent cardiovascular events (eg heart attack, stroke). These risk factors are not often formally addressed within a traditional chest pain clinic or cardiology clinic. The chest pain clinic provides an opportunity to identify patients at higher risk of subsequent cardiovascular events. We hypothesize that initiating strategies to modify individual risk factors during this initial visit will assist patients to develop a more favourable cardiovascular risk profile.
Interventions
Patients randomized to the intervention group will have a detailed discussion (with a cardiology nurse and treating cardiologist) regarding their cardiovascular risk, based on their 5-year risk calculation (using the Australian Absolute Risk Calculator - cvdcheck.org). This discussion will occur at the time of initial review at the Chest Pain Clinic, and is estimated to take around 40 minutes. The treating cardiologist will then develop an individualised risk management strategy in consultatio
Patients randomized to the intervention group will have a detailed discussion (with a cardiology nurse and treating cardiologist) regarding their cardiovascular risk, based on their 5-year risk calculation (using the Australian Absolute Risk Calculator - cvdcheck.org). This discussion will occur at the time of initial review at the Chest Pain Clinic, and is estimated to take around 40 minutes. The treating cardiologist will then develop an individualised risk management strategy in consultation with the patient, and communicated with their General Practitioner. The strategy will be based on the current recommendations of the National Heart Foundation Guidelines for management of cardiovascular risk. This may include lifestyle advice (exercise, dietary), prescription of lipid or blood pressure therapy where indicated, referral to the hospital's smoking cessation clinic +/- prescription of nicotine replacement therapy. Patients will be followed up via telephone (by a cardiology nurse) at 3, 6 and 9 month intervals, with in-person follow up at 12 months. At 12 months and five years, participants' absolute risk profile will be reassessed. Each contact point will provide an opportunity to monitor adherence to the agreed risk management strategy.
Sponsors
Royal Hobart Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
New patients referred to the chest pain service with uncomplicated chest pain suspicious of cardiac aetiology with intermediate to high baseline cardiovascular risk (>8% risk over 5 years)
Exclusion criteria
No prior cardiac history Pregnancy Subsequent primary cardiac diagnosis
Outcome results
None listed