Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study
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Aims The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic-based, nurse-led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged =45 years will be exposed to usual post-discharge care or the NIL-CHF intervention. The composite primary endpoint is all-cause mortality or CHF-related admission during 3?5 years of follow-up. After 12 months recruitment, 300 eligible patients (40 of target) have been randomized. Overall, 73 are male and the mean age is 65 ? 10 years. The most common antecedents for CHF thus far are hypertension (70 , 95 CI, 64?75 ), coronary artery disease (51 , 95 CI, 31?41 ), and type 2 diabetes (26 , 95 CI, 21?31 ), whereas 76 (95 CI, 69?82 ) of patients have diastolic dysfunction, 29 (95 CI, 23?36 ) left ventricular hypertrophy, 71 (95 CI, 64?78 ) mitral valve dysfunction, and 7 (95 CI, 4?12 ) have a left ventricular ejection fraction =45 . Conclusion As one of the largest randomized studies of its kind, NIL-CHF will ultimately provide important insights into the potential to prevent CHF via prolonged and intensive disease management.