Multifactorial lifestyle interventions aim ed at improving modifiable risk factors in patients with established CHD reduce the risk for fatal cardiovascular events .
Therefore , they may have added value in secondary prevention of CHD
CONTEXT Coronary heart disease ( CHD ) is responsible for about 15 % of all deaths worldwide and is identified as a top priority for decision makers .
Both primary and secondary prevention are considered key strategies in the prevention of CHD .
The aim of this study was to assess the efficacy of nonpharmacologic interventions with multiple lifestyle components in patients with established CHD in comparison to usual care .
GlObal Secondary Prevention strategiEs to Limit event recurrence after myocardial infarction: the GOSPEL study. A trial from the Italian Cardiac Rehabilitation Network: rationale and design
Background Cardiac rehabilitation programmes are a proven treatment for individuals with recent myocardial infa rct ion , result ing in reduced morbidity and mortality compared to usual care . Unfortunately , following completion of a cardiac rehabilitation programme , risk factors and lifestyle behaviours may deteriorate . The GlObal Secondary Prevention strategiEs to Limit event recurrence after myocardial infa rct ion ( GOSPEL ) study investigates the benefits of a programme of continued educational and behavioural interventions to achieve optimal long-term secondary prevention goals . Design This will be a multicentre , r and omized , controlled study carried out in 78 Italian cardiac rehabilitation centres . Methods After completion of an initial cardiac rehabilitation programme , patients with recent ( <3 months ) myocardial infa rct ion were r and omized to either a long-lasting ( over 3 years ) multifactorial continued educational and behavioural programme ( intensive approach ) or usual care ( control ) group . Intensive approach patients participated in extensive cardiac rehabilitation sessions , monthly from months 1 to 6 , then every 6 months for 3 years . Each session consisted of aerobic exercise , comprehensive lifestyle and risk factor counselling , and clinical assessment Usual care patients returned to their family physicians ’ care , and attended the reference centre only for the 6-month and then annual scheduled assessment . The efficacy of the two different strategies will be evaluated in terms of morbidity and mortality as primary endpoint . Results From January 2001 through December 2002 , 3241 patients were enrolled . Results will be available in mid 2006 . Conclusions The GOSPEL trial , the rationale and design of which we present here , was design ed to test a new strategy of secondary prevention delivery and to raise st and ards of long-term secondary prevention in Italy . With a cohort of over 3200 patients , GOSPEL is the largest r and omized , multifactorial lifestyle and risk factor intervention trial after myocardial infa rct ion conducted so far
Multifactorial lifestyle interventions aim ed at improving modifiable risk factors in patients with established CHD reduce the risk for fatal cardiovascular events .
Therefore , they may have added value in secondary prevention of CHD
CONTEXT Coronary heart disease ( CHD ) is responsible for about 15 % of all deaths worldwide and is identified as a top priority for decision makers .
Both primary and secondary prevention are considered key strategies in the prevention of CHD .
The aim of this study was to assess the efficacy of nonpharmacologic interventions with multiple lifestyle components in patients with established CHD in comparison to usual care .