Postmyocardial infarction education is effective but not enough on its own

Giannopoulos et al 1 report that delivering a stand-alone educational programme following myocardial infraction (MI) reduces the risk of cardiovascular events. This single-centre trial, based in university hospital Athens, randomised 329 postmyocardial patients to either an 8-week structured education plus usual care (intervention) or (control). The authors reported intervention consisted 10 hours contact on factor management, lifestyle and drugs, delivered by non-healthcare personnel with interactive patient sessions, aimed at enhancing adherence change treatment compliance. At mean follow-up 17 months, HR for primary composite outcome (all-cause death, MI, stroke hospitalisation) 0.48 (95% CI 0.32 0.73) major adverse cerebrovascular event 0.49 (0.27 0.28). With similar mortality both groups, improvements were driven reduced rates non-fatal events compared control: MI (13 vs 22), (2 7) hospitalisation (14 22). What is mechanistic basis this improvement events? As noted authors, factors likely be key explanation. Greater changes …