PLATFORM to Maximize Patient Knowledge of Health Goals After Acute Myocardial Infarction

The goals of this study are two fold: 1) To evaluate the impact of a personalized patient health goal education and reminder tool on patient adherence to evidence based therapies and subsequent cardiovascular risk factor modification after acute myocardial infarction (AMI); 2) To assess age-related heterogeneity in antiplatelet response among AMI patients. This is a prospective study of ~220 AMI patients, with at least half over age 65 years. Patients will be surveyed with questionnaires (at baseline and 6 months post discharge) and biomarkers (baseline only) to assess the status of their physical function, depression, nutrition, inflammation, and response to antiplatelet therapies. Patients will also be administered a walking test and a grip strength test at baseline. About 1 week after hospital discharge, and again about 3 months after hospital discharge, about half of the patients and their outpatient providers will receive the personalized post-AMI health goal education and reminder tool on patient adherence to evidence-based secondary prevention therapies. Data will be analyzed in aggregate using descriptive statistics. The primary endpoint of interest is a composite measure of adherence at six months to secondary prevention therapies described as the sum of measures received divided by the sum of available opportunities. The secondary endpoint will be analyzed to describe platelet response profiles as a function of age. The study team anticipates the risks for this study to be minimal, since the patient does not receive any investigational therapies.

Inclusion criteria

• Patients with either ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI) who are on antiplatelet therapy at the time of enrollment.
• English language literacy and
• Able to provide written informed consent.

Exclusion criteria

• Patients less than 18 years of age.
• Patients who are unable or unwilling to comply with the protocol or not expected to complete the study period, including its follow-up requirements
• Life expectancy less than 6 months or discharged on hospice care.
• Patients without at least 1 scheduled outpatient follow-up visit inside the Duke University Affiliated Physicians network.
• Patients who receive a coronary artery bypass grafting (CABG) during the eligible enrollment hospitalization.
• Active chronic inflammatory conditions (e.g., inflammatory bowel disease, lupus, rheumatoid arthritis)