Conclusions:

1. PERSPECTIVE STUDY OF PATIENTS WITH ISCHEMIC HEART DISEASE: IMPACT OF TELECARDIOLOGY ON THERAPY ADHERENCE AND SMOKING CESSATION Raffaele Piccari*, Lino Fabrizi*, Sergio Bartolini #, Paolo Pino *, Mascia Franchini *, Marco Pugliese *, Giovanni Pulignano *, Sergio Baldoni *, Luca Guerrieri* , A.Chiantera *. * 1 Cardiology Unit, San Camillo – Forlanini Hospital, Rome, Italy; # 2 Cardiology Unit, San Camillo – Forlanini Hospital, , Rome, Italy. Aim of the study Background The aim of this study was to evaluate the effect of ambulatory monitoring in patients with different acute coronary syndrome (ACS): ACS with persistent ST elevation, STEMI; ACS without persistent ST elevation, NSTEMI; Unstable Angina, UA. The patients were divided into two groups: one group was followed for a month with tele-monitoring and tele-assistance and subsequently for one year with ambulatory visit at 3-6-12 months evaluating, by means of interviews, the adherence to cardiovascular medications and the behaviour change, particularly assessing the smoking status; the other group was followed without counselling.  Nearly 50% of chronically ill patients have poor adherence to medications and to life-style change as results from a recent research of WHO. New interventions need for cardiovascular patients during in-hospital observation and after discharge. Methods The patients discharged from our hospital were followed from October 2007 to July 2009. In the first month, the tele-monitored patients were interviewed weekly with motivational interviewing in promoting adherence to cardiovascular medications (beta-blocker, ASA, statins) and smoking cessation by specialized research nurses. At the end of the first month an ambulatory interview were performed to evaluate the adherence to the interventional program. The ambulatory follow-up (A) was performed by trained cardiologist at 3, 6 and 12 months and with telephonic interviews of nurse staff at 2, 4 and 8 months. The patients who freely dropped the program after the first month, were included in the Usual Care Group (UC) and then contacted by phone one year later to verify compliance to therapy and to smoke quitting. p=0,057 Results: 737 patients (609 male) with a mean age of 60,6 + 11,1 years, STEMI 446 (61%), NSTEMI 185 (25%), UA 106 (14%). 517 patients (70%) were enrolled in the A follow-up, 155 patients (21%) who dropped the program were included in the UC Group. 48 patients (7%) dropped out and 6 patients (0,6%) died within the first month. Over the follow-up of 12 months, adherence to cardiovascular therapy was greater in Group A: beta-blocker (A 90.9% vs UC 76.2%; p=0,018), ASA (A 93.2% vs UC 87.3%; p=0,007) and statin (A 93.1% vs UC 80%; p=<0,001). At 1 month the persistent smokers were more in the UC group (A 24,7% vs UC 50%; p=0,011) but at 1 year the difference was lower (A 30,7% vs UC 52,8%;p=0,057). Conclusions: Motivational interviews performed by a trained and specialized nurse staff and ambulatory cardiologic checks in ACS patients improved compliance to cardiovascular medications and life-style change.  p=<0,001 Corresponding Author: Raffaele Piccari, 1st Cardiologic Operative Unit, e-mail: rpiccari@scamilloforlanini.rm.it Cardiologic Department, San Camillo-Forlanini Hospital,Circonvallazione Gianicolense 87, 00152 Rome, ITALY;phone+3906/58704419,fax+3906/58704361,