title: Coronary Artery RIsk MAnagement Programme (CARIMAP) delivered by a rehabilitation day-hospital: impact on patients with coronary artery disease.
abstract: OBJECTIVE
  Previous studies have shown that correct management of different coronary risk factors can reduce coronary event rates. However, significant undertreatment of hyperlipidemia, diabetes, and hypertension is still found during clinical practice. The purpose of this study was to evaluate the effectiveness of an individualized management program to modify coronary disease risk profile.
  
  
  METHODS
  One hundred sixty-eight patients discharged from a cardiac rehabilitation department after acute coronary events were prospectively randomized into 2 management strategies: 84 started usual community care and 84 entered a Coronary Artery RIsk MAnagement Programme (CARIMAP) delivered by the rehabilitation day-hospital. Coronary risk profile, optimized therapy, and management were evaluated after the acute event and again after a followup of 9 ± 4 months in both groups.
  
  
  RESULTS
  Patients accessed the day-hospital an average of 4 ± 1 months (range, 1-13 months) after the acute event. The duration of the CARIMAP was 5 ± 2 months and the individual number of accesses to the day-hospital was 4 ± 3.8. After the CARIMAP, patients received better-optimized therapy (β-blockers 57% vs 85%, P < .0001; angiotensin-converting enzyme inhibitors 54% vs 84%, P < .00001; statins 38% vs 78%, P < .0001; and amlodipine 22% vs 51%, P < .0001) and had a better risk profile (low-density lipoprotein-cholesterol < 100 mg/dL 30% vs 42%, P < .0001; blood pressure < 140/90 mmHg 63% vs 88%, P < .00001).
  
  
  CONCLUSIONS
  The CARIMAP of secondary prevention delivered by a rehabilitation day-hospital to patients who had undergone an acute coronary event, enabled individually titrated therapy and better control of coronary artery risk factors.
authors.affiliation: Unità Operativa di Riabilitazione Cardiorespiratoria Ospedale G. Criscuoli, Fondazione Don Carlo Gnocchi Onlus, Avellino, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Sturchio
authors.forename: Angela
authors.initials: A
authors.lastname: Di Gianni
authors.forename: Biagio
authors.initials: B
authors.lastname: Campana
authors.forename: MariaPina
authors.initials: M
authors.lastname: Genua
authors.forename: Michele
authors.initials: M
authors.lastname: Storti
authors.forename: Gabriella
authors.initials: G
authors.lastname: Di Iasi
authors.forename: Sara
authors.initials: S
authors.lastname: Monaco
authors.forename: Massimo
authors.initials: M
authors.lastname: Colella
authors.forename: Angela
authors.initials: A
authors.lastname: dello Buono
authors.forename: Emilia
authors.initials: E
authors.lastname: D'Addese
authors.forename: Soccorso
authors.initials: S
authors.lastname: Capomolla
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012307:Risk Factors; D012308:Risk Management / Q000379:methods*; D055502:Secondary Prevention / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D008055:Lipids