Utility of telephone text messages in secondary prevention after acute coronary syndrome

Abstract Introduction The recurrence of events in patients after an acute coronary syndrome (ACS) represents a great challenge for the health systems due to its high prevalence, morbidity and mortality, and cost. For this reason, secondary prevention measures with low cost and easy to implement are necessary. The objective is to evaluate the usefulness of telephone text messages (TTM) in the control of risk factors and reduction of events in the first year after an ACS. Methods Single-blind 1:1 randomized clinical trial in consecutive patients discharged with ACS between May 2019 and October 2021 in our center. The intervention group received a monthly TTM for 12 months with the recommendations of the Spanish Society of Cardiology regarding secondary prevention measures. Both groups followed the usual review protocol of our center in a specific ischemic heart disease consultation at 3 and 12 months after discharge. The center lacks cardiac rehabilitation. The objectives of the study at 12 months were: total and cardiovascular death, myocardial infarction, stroke, weight, blood pressure, LDL, HDL, triglycerides, glycosylated hemoglobin, smoking habit, and hours of exercise per week. The evaluator in charge of collecting data after the end of the year was unaware of the assignment group. Results N= 370. The patient profile was the usual one for ACS, with a mean age of around 65 years and 25% diabetic, with no differences in any of the baseline characteristics between both groups. An invasive approach was performed in almost all of the subjects, with percutaneous intervention in three-quarters of the cases and also without significant differences in the type of treatment, percentage of multivessel disease, and left main disease between both groups. Only a lower number of stents per patient was recorded in the control group. There were also no differences in medical treatment between both groups. The results are shown in the table. Conclusions In our study, monthly TTM had no influence on the control of risk factors or clinical events during the first year of follow-up after an ACS, and therefore it is not cost-effective to allocate resources for this purpose.