Bridging the gap in heart failure prevention: Rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

AimsThe primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF).MethodsNIL-CHF is a randomized controlled trial of a hybrid, home-and clinic-based, nurse-led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged ≥45 years will be exposed to usual post-discharge care or the NIL-CHF intervention. The composite primary endpoint is all-cause mortality or CHF-related admission during 3-5 years of follow-up. After 12 months recruitment, ∼300 eligible patients (40 of target) have been randomized. Overall, 73 are male and the mean age is 65 ± 10 years. The most common antecedents for CHF thus far are hypertension (70, 95 CI, 64-75), coronary artery disease (51, 95 CI, 31-41), and type 2 diabetes (26, 95 CI, 21-31), whereas 76 (95 CI, 69-82) of patients have diastolic dysfunction, 29 (95 CI, 23-36) left ventricular hypertrophy, 71 (95 CI, 64-78) mitral valve dysfunction, and 7 (95 CI, 4-12) have a left ventricular ejection fraction ≤45.ConclusionAs one of the largest randomized studies of its kind, NIL-CHF will ultimately provide important insights into the potential to prevent CHF via prolonged and intensive disease management.