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Diet Therapy Versus Prescriptive Educational Group Intervention in Overweight / Obese Patients at First Episode of AMI: a Randomized Controlled Trial

Not Applicable
Conditions
Obesity /Overweight
Acute Myocardial Infarction (STEMI/ NSTEMI)
Interventions
Behavioral: educational group intervention
Behavioral: prescriptive diet
Registration Number
NCT02323802
Lead Sponsor
Fondazione IRCCS Policlinico San Matteo di Pavia
Brief Summary

Results after interventions on lifestyle in the secondary prevention of ischemic heart disease are not always consistent, and the Guidelines multidisciplinary measures aren't easily achievable.

Therefore, the purpose of this research project is the identification of an interventional approach to effective secondary prevention and realistic feasibility, in a field of multifactorial risk. The study is open to patients who totaled a double chronic disease, obesity/overweight and coronary heart disease, and who experienced a first event of ischemic cardiac infarction (AMI). The aim is to evaluate the effectiveness of a group educational intervention in a sample of overweight and obese patients (BMI \> 24.9) incurred in a first episode of acute myocardial infarction (non-STEMI and STEMI), comparing with the classic approach of prescriptive diet therapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria

Subjects of both sexes and age ≥ of 18 years consecutively admitted to the Coronary Unit of IRCCS Foundation Policlinico S. Matteo, at first episode of STEMI or non-STEMI AMI, with BMI greater than 24.9.

Exclusion Criteria

Patients who can not provide informed consent (because illiterate or with significant language barrier or severe deficit/cognitive decays). Subjects with diseases and/or disabling organ damage. Subjects affected by active neoplasm. Individuals who have submitted arhythmic complications in acute and/or heart failure, or people referring to post-AMI residential rehabilitation. Subjects that are carriers of severe psychiatric disorders diagnosed by DSM-V -TR.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
educational group interventioneducational group interventionThe group educational food intervention: it provides the delivery of information leaflet and inclusion in groups on a weekly basis for the first 3 meetings, and then, there are other 2 meetings on the third and sixth month by the AMI. The meetings will cover education to self-nutrition, physical activity and learning techniques for stimulus control and management of high-risk situations.
prescriptive dietprescriptive dietAn objectives food scheme elaborated for each patients will provide the reduction in caloric intake (equivalent to 500-600 calories in deficit if compared to the estimated daily requirement, based on the RDAs) and a reduced intake of lipids, which does not exceed 30% of total calories introduced, with a contribution of saturated fat no more than 7-9% .
Primary Outcome Measures
NameTimeMethod
reduction of body weight6 months

The proportion of subjects with a 10% reduction in body weight at 6 months

Secondary Outcome Measures
NameTimeMethod
quality of life6 months

quality of life (assessed by SF-36 questionnaire at baseline and 6 months after infarction).

Reduction of reinfarction and revascularization1 year
general and specific mortality1 year

relative risk of death from all causes and from ischemic heart disease (no. of overall deaths and cardiovascular causes).

Trial Locations

Locations (2)

Internal Medicine Department, Clinica Medica II, IRCCS San Matteo Foundation

🇮🇹

Pavia, PV, Italy

Cardiology department

🇮🇹

Pavia, Italy

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