Nurse-led follow-up and digital health engagement in lipid-control after acute coronary syndrome

Effective secondary prevention after acute coronary syndrome (ACS) requires sustained patient education, regular follow-up, and active engagement in care beyond pharmacological treatment. Cardiovascular nurses play a pivotal role by reinforcing adherence to recommended laboratory monitoring, supporting continuity of care, and facilitating patients’ use of digital health services, thereby enhancing health and digital health literacy. Evidence linking these nurse-supported processes to lipid outcomes remains limited.

To examine the associations between indicators of nurse-supported follow-up, digital health engagement, and lipid profile parameters in patients after ACS.

A cross-sectional observational study was conducted among 761 patients following ACS. Data included sociodemographic and clinical characteristics, frequency of blood testing, continuity of follow-up (follow-up by a specific physician and recency of cardiology assessment), and use of digital health services (electronic prescription and online appointment booking). These variables were used as indicators of structured, nurse-supported follow-up. LDL-C and HDL-C levels were analyzed in relation to follow-up patterns and digital engagement.

Participants were predominantly male (76.3%), with a mean age of 64.4 ± 12.4 years. Regular follow-up, more frequent laboratory monitoring, and engagement in digital health services were associated with more favorable lipid profiles. More frequent lipid monitoring was linked to significantly lower LDL-C levels compared with annual or less frequent (p = 0.001). Use of electronic prescription services was associated with lower LDL-C levels, while online appointment booking was associated with higher HDL-C levels. In contrast, patients lacking continuity of follow-up and digital engagement showed poorer monitoring patterns and less optimal lipid control.

Structured nurse-led follow-up, supporting continuity of care, regular monitoring, and digital health engagement, is associated with improved lipid control after ACS. These findings support the expanding role of cardiovascular nurses as key coordinators of guideline-based secondary prevention and digital health engagement after ACS. This nurse-supported model reflects real-world clinical practice and may be transferable to similar post-ACS care settings.