Amélioration du pronostic des syndromes coronaires aigus dans les Landes par la modification de l'hygiène de vie

The global coverage of the patients having had an acute coronary syndrome requires the modification of their life hygiene. Six hundred and sixty-seven consecutive victims of this syndrome benefited from clinics by a nurse, aiming at decreasing their risk factors and to modify their food customs. The initial interrogation allows the collection of these items and every answer is transformed into a digital score. The patients being seen again every 6 months in consultation, progress was observed, not only for the control of the risk factors (the score passes from 6.4 to 5.1, P < 0.001) but also for that of the food customs (the score passes from 1.5 to -6, P < 0.001). The evolution of the patients was compared as they are (group 1, N = 216) or not (group 2, N = 448) followed regularly in consultation, on the basis of a voluntary service, with a follow-up of 20, 8 months. Three patients were lost sight. The patients of the group 1 have fewer cardiovascular events (17 patients with event vs 82, P < 0.02), in particular a cardiac insufficiency (2 vs 28, P < 0.01) or the other events bound to the atherosclerosis (13 vs 55, P < 0.02), They are less often hospitalised (14 vs 70, P < 0.001). The deaths are less frequent in group 1 (Curve of Kaplan-Meyer: P < 0.01; RR = 0.23; IC = 0.09-0.58. The bad hygiene of life, which led to the arisen of an acute coronary syndrome, can be corrected and this is translated by an improved prognosis.