CONGRESS ABSTRACT

Background: The first year after an admission for an Acute Coronary Syndrome (ACS) is the most critical time with the highest incidence of deaths and hospital readmissions. To improve the first-year follow-up after discharge of patients admitted to our ICCU (Intensive Cardiac Care Unit) and Cardiology ward for ACS in accordance with international guidelines, the first of November 2022 was launched the DIMACC project (‘Dimissioni Accompagnate’, i.e. Accompanied Discharge). Aim: To assess the feasibility and main results of the pilot phase of the DIMACC project. Methods: The DIMACC project is a prospective quality improvement study in real-world practice. At discharge each patient receives a list of health objectives to be achieved on blood pressure, heart rate and weight, blood test results, symptoms, lifestyles and adherence to cardiovascular therapy. The 12-month follow-up consists of different structured pathways of visits and tests according to patient’s clinical picture. Data on the achievement of health targets were collected by nurses during the follow-up visits on the basis of the answers to questionnaires administered to patients, measurements made in the clinic and evaluation of blood test results. Results: From 1.11.22 to 30.4.23, 129 patients (71%) out of 182 admitted for ACS to the ICCU and Cardiology ward of Pio XI hospital in Desio were included in the project: 1 patient died, 11 (8%) were lost to follow-up and 117 (91%) were followed up for one year. The percentage of patients that achieved at 12 months the health objectives agreed on at discharge is shown in the figure. There is a good adherence to drug treatments and an optimal symptoms’ control. The most critical issues are related to low-density lipoprotein-cholesterol control (<55 mg/dl in 43% of cases) and to practice of physical activity (≧30 minutes per day for at least 5 days/week in 30% of cases). Conclusions: The structured 12-month follow-up is feasible and only a minority of patients did not complete the pathway of visits and tests. The attainment of health objectives ranged from 30% to 99%. On average each patient misses 1 every 4 health objectives. The regular measurement of targets achieved by the patients allows the identification of problems and may suggest strategies for implementing changes to improve the quality of care.