Nurse Follow-Up Reduces CV Events After Acute Coronary Syndrome | ACC 2025

Nurses play a critical role in reducing serious cardiovascular events after patients experience acute coronary syndrome (ACS), according to study results presented today at the American College of Cardiology Annual Scientific Session and Expo. Patients who were counseled on heart medications and lifestyle modifications by specially trained nurses were 30% less likely to experience cardiovascular death, heart attack or stroke five years after being hospitalized for acute coronary syndrome.

Laura Davidson, M.D.

“This study is important because it highlights that not just physicians are at the forefront of helping patients. It is a true team effort from a lot of people that are involved with patient care,” Laura Davidson, M.D., member of the ACC Interventional Council, said during a press conference where these results were presented.

“This can be a very devastating diagnosis for a lot of patients, and it happens very suddenly and can warrant a lot of lifestyle changes at a very quick pace," said Davidson, who was not involved with the study.

In the United States, about 1.2 million are hospitalized because of acute coronary syndrome, which includes heart attacks. ACS is a leading cause of cardiovascular morbidity and mortality. Medication and lifestyle medication are standard care after a heart attack.

Giulia Magnani, M.D., Ph.D.

Giulia Magnani, M.D., Ph.D., and her colleagues at Parma University Hospital in Parma, Italy, wanted to assess whether a nurse-led cardiology intervention could reduce further cardiac events in patients who have experienced acute coronary syndrome.

In the ALLEPRE study, researchers enrolled 2,057 patients treated for acute coronary syndrome at seven hospitals in Italy. The study included 250 nurses who had been trained to provide a standard approach that included cardiovascular risk assessment, promotion of healthy lifestyle and monitoring for patient adherence.

Half of the patients received nurse-led follow-up, and half received standard care. Patients who received nurse-led care had at least nine one-on-one sessions with a nurse coordinator starting while they were hospitalized and at one, three, six, 12, 18, 24, 36 and 48 months after discharge. Patients who received standard care followed the usual protocol for their treating hospital, which included at least three follow-up visits with their cardiologist over five years following their ACS hospitalization.

The study’s composite endpoint was the rate of cardiovascular death, nonfatal heart attack or nonfatal stroke.

Researchers found that at five years, the rate of cardiovascular death, non-fatal heart attack or non-fatal stroke was 30% lower among patients receiving nurse-led follow-up care. This was primarily driven by a significant reduction in non-fatal heart attacks. Rates of cardiovascular death or stroke were numerically lower among patients receiving nurse-led care, but the difference between groups was not statistically significant.

The greatest impact of the nurse-led care was on lifestyle modifications, particularly increased physical activity intensity, BMI control, and improved medication adherence. Researchers also found that patients receiving nurse-led follow-up showed improvements in physical activity and medication adherence,, but there was no difference between groups in terms of smoking cessation or low-density lipoprotein (LDL) cholesterol.

“Our findings highlight the nurse as a key figure in the secondary prevention of the acute coronary syndrome patient,” Magnani said during the press conference. “Of course, further study will be necessary in order to prove this data in other healthcare settings, and also cost-effectiveness analyses will be needed.”