EFFECT OF NURSE-GUIDED NUTRITION INTERVENTIONS ON LIPID PROFILE, DIETARY COMPLIANCE, AND CARDIOVASCULAR OUTCOMES IN CORONARY ARTERY DISEASE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, with dyslipidemia and poor dietary adherence representing modifiable risk factors. Nurse-guided nutrition interventions have emerged as a promising strategy for secondary prevention, yet their comprehensive effects on lipid profiles, dietary compliance, and cardiovascular outcomes remain incompletely synthesized.

Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. We searched SciSpace, Google Scholar, and PubMed databases from January 2010 to September 2026 for randomized controlled trials (RCTs), meta-analyses, and observational studies evaluating nurse-guided nutrition interventions in CAD patients. Studies were included if they reported outcomes on lipid profiles (LDL-C, HDL-C, total cholesterol, triglycerides), dietary compliance, or cardiovascular events. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2.0 tool and GRADE framework. Statistical analyses employed random-effects models with heterogeneity assessed via I² statistics.

Results: From 431 initial records, 22 studies involving over 3,000 CAD patients were included after removing 85 duplicates and screening 346 unique records. Nurse-guided nutrition interventions demonstrated significant improvements in lipid profiles: LDL cholesterol decreased by 0.47–0.76 mmol/L (weighted mean difference [WMD]: −0.61 mmol/L, 95% CI: −0.92 to −0.30, p = 0.0001), total cholesterol decreased by WMD −0.63 mmol/L (95% CI: −0.97 to −0.30, p = 0.0002), HDL cholesterol increased by WMD 0.06 mmol/L (95% CI: 0.03 to 0.09, p = 0.0005), and triglycerides decreased by 42.39–62.51 mg/dL. Dietary adherence improved substantially, with Mediterranean diet scores increasing by +2.1 units (p < 0.001) and adherence rates ranging from 26% to 96% across studies. Cardiovascular outcomes showed reduced major adverse cardiovascular events (MACE), lower rehospitalization rates, and improved quality of life. Heterogeneity was moderate to high (I² = 45–78%) across outcomes.

Conclusions: Nurse-guided nutrition interventions significantly improve lipid profiles, enhance dietary compliance, and reduce cardiovascular events in CAD patients. These findings support the integration of nurse-led nutritional counseling into standard cardiac rehabilitation and secondary prevention programs. Future research should focus on long-term sustainability, cost-effectiveness, and optimal intervention components.