Valuable Clinical Tool Helps Prevent Repeat Heart Attacks, Complications and Hospital Readmissions

The CCS Secondary Prevention Pathway aims to guide clinicians and cardiac patients
to optimal care, and drive efficiencies in health-care systems.  

In an effort to improve recovery and patient outcomes after a heart attack, the Canadian Cardiovascular Society (CCS) has developed a comprehensive step-by-step pathway and tools for clinicians and patients to guide the best possible care after discharge from hospital.

The goals are to ensure people recover well and don’t end up back in hospital, save lives, and reduce the staggering pressures on provincial health-care systems, described by policymakers and politicians in recent news reports as ‘unsustainable’.

“Care after a heart attack is complex,” says Dr. JD Schwalm, CCS member from McMaster University, who co-chaired the CCS Secondary Prevention Pathway Working Group. “This pathway helps bridge evidence-to-practice gaps, standardize secondary prevention care and has the potential for scale and spread across Canada to optimize patient outcomes.”

The pathway includes clear and practical guidance on referral to cardiac rehabilitation, management of medication and risk factors, follow-up assessments and screenings, healthy eating recommendations, lifestyle changes, social and mental health counselling, and more. To support patients and their careers, the CCS has also developed a resource called “Your Health After a Heart Attack” to provide information about what to expect and do after discharge from hospital.

“While initially developed for use in Ontario, a pan-Canadian team will guide national adaptation and implementation of the pathway this year,” Dr. Schwalm says.

More than a million Canadians are living with atherosclerotic cardiovascular disease (plaque buildup in the arteries of their heart). Many have had a heart attack and 50 percent will have another without optimal care.

As it stands, fewer than half of heart attack patients are referred to cardiac rehabilitation programs or receive regular testing and treatment for high cholesterol, for example. Knowledge gaps, poor communication among health professionals, and a lack of clarity around roles and responsibilities have been identified as the issues, which the pathway aims to address.

In addition to improving knowledge and communication among clinicians, the pathway seeks to educate and empower patients and families on medications, blood-pressure management, and symptom monitoring.

Also included with the pathway is a concise overview for family physicians as they work in partnership with multidisciplinary teams to ensure patients receive all the services, therapies and tests they require to prevent another heart attack and reduce the risk of death.

The CCS Secondary Prevention Pathway Working Group included cardiologists, pharmacists, nurse practitioners, primary care clinicians, trainees, people with lived experience, Ontario Health representatives, and industry partners.

“This pathway is good for clinicians, good for patients and good for the health-care system,” says Dr. Schwalm. “Using it will save resources in the long run. Most important, the delivery of optimal care will improve the lives of Canadians living with heart disease.”

The pathway can be found here on the Canadian Cardiovascular Society website, along with a number of other resources including a webinar, poster, slide deck, the family physician overview, and resources for patients and family carers. Read the publication in the Canadian Journal of Cardiology here.