CONGRESS ABSTRACT

Introduction: The reduction of mortality from acute coronary syndrome obtained thanks to the development of emergency networks and early percutaneous coronary revascularization does not correspond to mortality from ischemic heart disease one year after the acute event. Ischemic heart disease is still the leading cause of death in Italy and the rest of the world. This is due to the low frequency with which discharged patients are included in secondary prevention programs and the disjointed relationship between the hospital specialist and the local specialist/general practitioner, between the hospital and territorial healthcare service. Materials and Methods: Patients discharged from our department after an acute coronary syndrome are sent to the secondary prevention clinic for ischemic heart disease, with an appointment within one month of discharge. In this context, they are followed for six months, with a diagnostic and therapeutic process useful for achieving the targets recommended by the guidelines regarding the control of cardiovascular risk factors, to monitor adherence to prescribed therapy and lifestyle changes. Subsequently, through an exclusive booking agenda, the cardiological outpatient check-up is scheduled at the competent local cardiology department considering the patient's residence. Results: the percentage of rehospitalization at our O.U. or other departments of the province, of patients followed at a hospital outpatient clinic was 1.9% one year after the acute event, with a mortality of 0.13%. In 2013, 84 patients were referred to territorial healthcare cardiology service; In the first 10 months of the year 2024, 190 patients were sent to territorial healthcare cardiology service. All patients were followed with an organizational model that provides for a continuous stratification of cardiovascular risk through at least two outpatient check-ups per year. Of these, none had a further hospitalization for cardiological causes. Conclusions: in an era characterized by economic crisis and staff shortage, a rationalization of available resources with the development of continuity of care between hospital and territory can allow a reduction in healthcare spending, mainly due to pre-hospitalization, and contribute to reducing patient mortality for ischemic heart disease.