Effect of "Five-in-one" follow-up management modein secondary prevention of acute myocardial infarction and diabetes in patients

  Objective  To investigate the effect of "Five-in-one" follow-up management mode in secondary prevention of acute myocardial infarction and diabetes in patients.

  Methods  From January to December 2018, a total of 200 acute myocardial infarction patients with type 2 diabetes mellitus by treatment of percutaneous coronary intervention (PCI) in Shaanxi Provincial People's Hospital were selected, and they were divided into observation group ("Five-in-one" follow-up management mode) with 103 cases and control group (traditional outpatient follow-up) with 97 cases according to willingness of follow up after hospital discharge. One year after follow-up, indexes such as fasting blood glucose, glycosylated hemoglobin, urinary protein, urinary sugar, standard rate of blood pressure, standard rate of blood lipid, body mass index (BMI), smoking cessation rate, standard rate of physical activity, medication compliance, cumulative loss rate of follow-up and major adverse cardiovascular events (MACE) were compared between the two groups.

  Results  After 1-year follow-up, there were 5 cases lost during follow-up in the observation group and 24 cases in the control group. There were significant differences in cumulative loss rate of follow-up, incidence of MACE, standard rate of physical activity, smoking cessation rate, standard rate of blood pressure, positive rate of urinary protein and positive rate of urinary sugar between the two groups (P < 0.05). In the observation group, the medication rates of β-receptor blockers, statins, angiotensin converting enzyme inhibitors and angiotensin Ⅱ receptor antagonists (ACEI/ARB), and dual antiplatelet drugs were significantly higher than those in the control group, while the mean systolic blood pressure, diastolic blood pressure, BMI, fasting blood glucose, glycosylated hemoglobin and uric acid levels were significantly lower than those in the control group (P < 0.05).

  Conclusion  "Five-in-one" follow-up management model can effectively control the risk factors of acute myocardial infarction patients with diabetes, improve medication compliance, standardize the drug use for secondary prevention of coronary heart disease, and reduce the incidence of cardiovascular events.