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January 20, 2026European Journal of Cardiovascular NursingOpen Access

Nurse-led clinics reduce CHD exacerbations ~13% vs. usual care without affecting mortality.

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Why the study?

Nurse-led clinics can potentially provide effective secondary prevention for CHD, prompting an updated systematic review to determine their effectiveness on mortality, morbidity, and other clinical and patient outcomes.

Do nurse-led clinics reduce mortality and morbidity in adults with coronary heart disease compared to usual care?

Comparison

Nurse-led clinics vs usual care by another healthcare professional

Design

Systematic review and meta-analysis of randomized controlled trials

Key result

Nurse-led clinics for adults with coronary heart disease resulted in no significant difference in mortality (RR 0.91; 95% CI 0.59-1.40; P=0.67) but slightly reduced CHD exacerbations.

Authors

AAAinagul AlzhanovaVSVerena SchadewaldtJHJ. Hendriks

Discussion

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Overview

Supports nurse-led clinics for CHD secondary prevention to cut exacerbations; strengthens RCT meta-analytic evidence without mortality benefit.

Key Points

  • This review assesses the effectiveness of nurse-led clinics for patients with coronary heart disease on various health outcomes.
  • Conducted a systematic review and meta-analysis of randomized controlled trials
  • Used Joanna Briggs Institute guidelines and RoB 2 for appraisal
  • Analyzed data with RevMan software and applied GRADE for evidence certainty
  • Included 29 trials comparing nurse-led clinics with usual care
  • Evaluated clinical and patient-related outcomes like mortality, morbidity, and risk factors.
  • No significant difference in mortality rates between nurse-led clinics and usual care (RR 0.91)
  • Slight reduction in coronary heart disease exacerbations observed (RR 0.87)
  • Moderate certainty evidence for slight decreases in cholesterol and blood pressure levels
  • Low-moderate certainty evidence for better adherence to medications and improved health-related quality of life
  • Behavioral outcomes, such as exercise and smoking cessation, showed promise but require further research.

Study Design

Type

Meta-Analysis

Structured PICO

Do nurse-led clinics reduce mortality and morbidity in adults with coronary heart disease compared to usual care?

P
Population
Twenty-nine randomized controlled trials evaluating nurse-led clinics versus usual care in adults with existing or newly diagnosed coronary heart disease.
I
Intervention
Nurse-led clinics for secondary prevention
C
Comparator
Usual care by another healthcare professional
O
Outcome
Mortality and coronary heart disease (CHD) exacerbationshard clinical

Main Result

Relative Risk: 0.91 (95% CI 0.59–1.4)

p-value: p=0.67

Nurse-led clinics for secondary prevention of coronary heart disease effectively reduce CHD exacerbations and improve risk factor management and medication adherence compared to usual care.

Cite This Study

Alzhanova et al. (2025) conducted a meta-analysis in Coronary heart disease. Nurse-led clinics vs. Usual care by another healthcare professional was evaluated on Mortality (RR 0.91, 95% CI 0.59-1.40, p=0.67). Nurse-led clinics for adults with coronary heart disease resulted in no significant difference in mortality (RR 0.91; 95% CI 0.59-1.40; P=0.67) but slightly reduced CHD exacerbations.

synapsesocial.com/papers/696f1a629e64f732b51eea06https://doi.org/10.1093/eurjcn/zvaf207
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