J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 4, Number 2, April 2012, pages 102-109

Cardiovascular Risk Management With Liaison Critical Path in Japan: Its Effects on Implementation of Evidence-Based Prevention in Practice

Figure 1. Prescription of several classes of cardioprotective medicines in clinical practice with liaison critical path. Proportions of the patients who were prescribed anti-platelet agents, statins, β-blockers, angiotensin-converting enzyme inhibitors (ACE-Is)/angiotensin II type I receptor blockers (ARBs), and calcium channel (Ca) blockers are shown at indicated times. Six-month (6M) and 12-month (12M) visits were scheduled at 6 ± 3 months and 12 ± 3 months after hospital discharge, respectively. Statistical analyses were performed by chi-square test. #: P < 0.05 vs. on discharge.

**Table 1.** Baseline Characteristics of the Subjects
	Without LCP	With LCP	P^#
^# Statistical analyses were performed by Student’s t-test or chi-square test (*). LCP, liaison critical path; AMI, acute myocardial infarction; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.
Number of patients	140	318
Age (y)	70.8 ± 9.3	69.2 ± 9.9	0.093
Male (%)	66.4	74.2	0.088*
Coronary artery disease
AMI (%)	29.3	28.9	0.939*
Others (%)	70.7	71.1
BMI (kg/m²)	23.3 ± 3.7	24.1 ± 4.0	0.089
Blood Pressure
Systolic (mmHg)	133.4 ± 25.3	129.4 ± 20.1	0.058
Diastolic (mmHg)	72.6 ± 15.4	72.8 ± 12.7	0.999
Laboratory
Triglycerides (mg/dL)	118.5 ± 79.3	125.7 ± 72.2	0.357
HDL-C (mg/dL)	44.4 ± 13.1	44.4 ± 11.7	0.900
LDL-C (mg/dL)	100.7 ± 32.3	104.1 ± 30.3	0.291
HbA1c (%)	6.7 ± 1.6	6.3 ± 1.3	< 0.001

Table 1. Baseline Characteristics of the Subjects

Without LCP

With LCP

P^#

(Jan.-Dec. 2006)

(Oct. 2007-Jun. 2010)

^# Statistical analyses were performed by Student’s t-test or chi-square test (*). LCP, liaison critical path; AMI, acute myocardial infarction; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.

Number of patients

140

318

Age (y)

70.8 ± 9.3

69.2 ± 9.9

0.093

Male (%)

66.4

74.2

0.088*

Coronary artery disease

AMI (%)

29.3

28.9

0.939*

Others (%)

70.7

71.1

BMI (kg/m²)

23.3 ± 3.7

24.1 ± 4.0

0.089

Blood Pressure

Systolic (mmHg)

133.4 ± 25.3

129.4 ± 20.1

0.058

Diastolic (mmHg)

72.6 ± 15.4

72.8 ± 12.7

0.999

Laboratory

Triglycerides (mg/dL)

118.5 ± 79.3

125.7 ± 72.2

0.357

HDL-C (mg/dL)

44.4 ± 13.1

44.4 ± 11.7

0.900

LDL-C (mg/dL)

100.7 ± 32.3

104.1 ± 30.3

0.291

HbA1c (%)

6.7 ± 1.6

6.3 ± 1.3

< 0.001

**Table 2.** Implementation of Follow-up Hospital Visits With or Without Liaison Critical Path
	Without LCP	With LCP	P^#
^# Statistical analyses were performed by chi-square test. LCP, liaison critical path.
Total subjects, n	140	318
6-month visit, n (%)	75 (53.6)	280 (88.1)	< 0.001
12-month visit, n (%)	71 (50.7)	284 (89.3)	< 0.001

Table 2. Implementation of Follow-up Hospital Visits With or Without Liaison Critical Path

Without LCP

With LCP

P^#

(Jan.-Dec. 2006)

(Oct. 2007-Jun. 2010)

^# Statistical analyses were performed by chi-square test. LCP, liaison critical path.

Total subjects, n

140

318

6-month visit, n (%)

75 (53.6)

280 (88.1)

< 0.001

12-month visit, n (%)

71 (50.7)

284 (89.3)

< 0.001

**Table 3.** Management of Coronary Artery Disease Patients by Cardiologists and Non-Cardiologists With Liaison Critical Path
	Cardiologist	Non-cardiologist	P^#
^# Statistical analyses were performed by chi-square test. BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.
Implementation of scheduled visit
6-month visit, (%)	86.2	89.4	0.386
12-month visit, (%)	85.4	92.0	0.060
Achievement of targets (12-month)
BMI < 25 kg/m², (%)	72.1	66.3	0.307
Blood pressure < 130/80 mmHg, (%)	51.4	55.7	0.482
Triglycerides < 150 mg/dL, (%)	80.0	80.8	0.865
HDL-C ≥ 40 mg/dL, (%)	80.8	83.9	0.503
LDL-C < 100 mg/dL, (%)	69.2	61.3	0.185
HbA1c < 7.0 %, (%)	88.8	81.8	0.123

Table 3. Management of Coronary Artery Disease Patients by Cardiologists and Non-Cardiologists With Liaison Critical Path

Cardiologist

Non-cardiologist

P^#

(n = 45)

(n = 74)

^# Statistical analyses were performed by chi-square test. BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.

Implementation of scheduled visit

6-month visit, (%)

86.2

89.4

0.386

12-month visit, (%)

85.4

92.0

0.060

Achievement of targets (12-month)

BMI < 25 kg/m², (%)

72.1

66.3

0.307

Blood pressure < 130/80 mmHg, (%)

51.4

55.7

0.482

Triglycerides < 150 mg/dL, (%)

80.0

80.8

0.865

HDL-C ≥ 40 mg/dL, (%)

80.8

83.9

0.503

LDL-C < 100 mg/dL, (%)

69.2

61.3

0.185

HbA1c < 7.0 %, (%)

88.8

81.8

0.123