The proposed study is a randomized clinical trial of behavioral interventions to modify dietary, exercise, and smoking behaviors as well as pharmacologic treatment delivered by a nurse case manager compared with usual care administered by primary care providers in the traditional medical system. Two hundred forty CABG patients who meet eligibility criteria will be randomly assigned to the nursing intervention group or the usual care group and followed for outcome evaluation at 6, 12, and 24 months. The major outcomes will be 1) achievement of nationally recognized goal levels of LDL-cholesterol, 2) impact of cholesterol-lowering therapy on quality of life, and 3) cost-effectiveness of the lipid-lowering program. Statistical analysis will focus on the proportion in each group who achieve goal at the follow-up periods. Survival analysis will be used to examine the effect of the intervention on the timing of patients reaching goal levels. In addition, multiple logistic regression analysis will be performed to determine the best set of predictors of risk factor goal attainment in the overall group. Quality of life by study group over time will be examined using MANOVA. Comparisons of the cost per percentage decrease in LDL-cholesterol between the nurse-managed and usual care groups will be analyzed with cost-effectiveness ratios.
| Miller 3rd, Edgar R; Erlinger, Thomas P; Blumenthal, Roger S et al. (2003) Antibodies to oxidized low-density lipoprotein in patients following coronary artery revascularization. Coron Artery Dis 14:163-9 |
