title: [Management of coronary atherosclerotic heart disease through an alliance of community and hospital].
abstract: OBJECTIVE
  To evaluate the effect of out-hospital normalized management of coronary heart disease (CAD) on the end point events such as mortality, readmission, etc, and on the compliance of patients through normalized management by an alliance of community and hospital.
  
  
  METHODS
  The samples were comprised of a total of 2000 patients in 15 communities. And 1642 patients agreed to a follow-up and signed a consent form. Ten communities were chosen as the intensive management group in which community clinicians were trained and the patient management plan was proposed and carried out. The remaining 5 communities were taken as the control group in which the community clinicians were not trained and the patients received only general management. Both groups received a follow-up of 23 months.
  
  
  RESULTS
  Compared with the control group, the intensive manage group showed a lower risk of all-cause death, cardiac death and readmission due to cardiovascular events (CVE). They declined by 36.5% (OR 0.635, 95%CI 0.478-0.854), 41.5% (OR 0.585, 95%CI 0.428-0.800) and 56.1% (OR 0.439, 95%CI 0.315-0.612) respectively. The proportion of patients with NYHA III in the intensive management and control groups increased by 3.6% and 7.7% while that of the counterparts of NYHAIV in two groups increased by 1.6% and 6.4% respectively. The cardiac function in the patients of intensive management group was significantly superior to that in control group. Patients in both groups displayed an acceptable compliance to cardiac medications except for aspirin. The proportion of aspirin in the intensive management and control groups increased by 8.4% and 8.7% respectively (P<0.05).
  
  
  CONCLUSIONS
  Through normalized management provided by an alliance of community and hospital, the rates of all-cause death and readmission due to CVE decrease significantly concurrently with an improvement of cardiac function and quality of life in CAD patients.
authors.affiliation: Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou 310006, China.
authors.forename: Yi-gang
authors.initials: YG
authors.lastname: Zhong
authors.forename: Ning-fu
authors.initials: NF
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Shi-zun
authors.initials: SZ
authors.lastname: Guo
authors.forename: Zhan-lin
authors.initials: ZL
authors.lastname: Zhou
authors.forename: Guo-xin
authors.initials: GX
authors.lastname: Tong
authors.forename: Jian
authors.initials: J
authors.lastname: Lin
authors.forename: Guo-an
authors.initials: GA
authors.lastname: Sheng
authors.forename: Yi-bo
authors.initials: YB
authors.lastname: Wang
authors.forename: Peng
authors.initials: P
authors.lastname: Xu
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Zou
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies