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Bridging the gap in heart failure prevention: rationale and design of the Nurse‐led Intervention for Less Chronic Heart Failure (NIL‐CHF) Study
Author(s) -
Carrington Melinda J.,
Stewart Simon
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp161
Subject(s) - medicine , heart failure , bridging (networking) , intervention (counseling) , cardiology , intensive care medicine , nursing , computer network , computer science
Aims The primary objective of the Nurse‐led Intervention for Less Chronic Heart Failure (NIL‐CHF) Study is to develop a programme of care that cost‐effectively prevents the development of chronic heart failure (CHF). Methods NIL‐CHF is a randomized controlled trial of a hybrid, home‐ and clinic‐based, nurse‐led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged ≥45 years will be exposed to usual post‐discharge care or the NIL‐CHF intervention. The composite primary endpoint is all‐cause mortality or CHF‐related admission during 3–5 years of follow‐up. After 12 months recruitment, ∼300 eligible patients (40% of target) have been randomized. Overall, 73% are male and the mean age is 65 ± 10 years. The most common antecedents for CHF thus far are hypertension (70%, 95% CI, 64–75%), coronary artery disease (51%, 95% CI, 31–41%), and type 2 diabetes (26%, 95% CI, 21–31%), whereas 76% (95% CI, 69–82%) of patients have diastolic dysfunction, 29% (95% CI, 23–36%) left ventricular hypertrophy, 71% (95% CI, 64–78%) mitral valve dysfunction, and 7% (95% CI, 4–12%) have a left ventricular ejection fraction ≤45%. Conclusion As one of the largest randomized studies of its kind, NIL‐CHF will ultimately provide important insights into the potential to prevent CHF via prolonged and intensive disease management.