Effect of nutritional nursing intervention on patients with acute ST-segment elevation myocardial infarction accompanied by iron deficiency.

Introduction

we aimed to assess the effect of nutritional nursing intervention on patients with acute ST-segment elevation myocardial infarction (STEMI) accompanied by iron deficiency.

Methods

this study comprised a prospective observational cohort phase and a nested randomized controlled trial (RCT) phase. In the prospective study phase, 200 patients with a first acute STEMI were consecutively enrolled, of whom 92 were subsequently diagnosed with iron deficiency. In the RCT phase, 90 patients were randomly assigned to conventional nursing, medical-therapy, or nursing intervention group for 12 weeks, with follow-up for six months.

Results

after 12 weeks of intervention, the nursing intervention group had significantly higher scores on the eight-item Morisky Medication Adherence Scale than those of medical-therapy and conventional nursing groups (7.3 ± 0.8 vs 6.2 ± 1.0 vs 5.8 ± 1.1, p < 0.001). During the six-month follow-up, the rate of readmission for heart failure was significantly lower in the nursing intervention group than in medical-therapy and conventional nursing groups (6.7 % vs 23.3 % vs 26.7 %). Logistic regression analysis revealed that the risk of readmission reduced (odds ratio = 0.17, 95 % confidence interval: 0.03-0.85, p = 0.031). The left ventricular ejection fraction of the nursing intervention group improved the most (Δ = 7.4 %, p < 0.001), and the improvements in Six Minute Walk Distance (6MWD) test and Kansas City Cardiovascular Questionnaire (KCCQ) scores were also significantly higher than those in the other two groups (p < 0.001).

Conclusion

nutritional nursing intervention effectively improved patients' medication compliance, reduced the risk of re-hospitalization for heart failure, and improved their quality of life.