ORGANIZATION OF SECONDARY PREVENTION FOR CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW OF IMPLEMENTED MODELS AND THEIR COMPONENTS

Introduction. Secondary prevention of coronary artery disease requires not only evidence-based pharmacological and non-pharmacological interventions but also effective organization of their delivery in routine clinical practice. Different healthcare systems use different models of care integrating patient follow-up, risk-factor management, medication management, rehabilitation, and coordination across levels of care. Aim. To systematically identify implemented models for organizing secondary prevention of coronary artery disease, characterize their key organizational components, and summarize their reported outcomes. Materials and methods. A systematic review of studies identified in PubMed, Scopus, and Web of Science was conducted. Studies involving patients with established coronary artery disease were included if they described an implemented secondary-prevention model incorporating structured follow-up and coordination of care. Results. A total of 51 publications representing 42 unique models of care were included. Six major types were identified: nurse-led or nurse-coordinated care (11; 26.2%), telehealth or hybrid care (11; 26.2%), shared cardiology–primary care (7; 16.7%), comprehensive cardiac rehabilitation (6; 14.3%), integrated or multidisciplinary care (4; 9.5%), and coordinated post- myocardial infarction pathways (3; 7.1%). Despite differences in organizational architecture, recurring components included care coordination, planned follow-up, medication management, risk-factor monitoring, lifestyle support, and mechanisms for referral or escalation to specialist care. Improvements were most consistently reported for cardiovascular risk-factor control, treatment adherence, and lifestyle-related outcomes. Findings for mortality, cardiovascular events, and hospitalizations were less consistent. Conclusion. No single organizational model of secondary prevention for coronary artery disease was identified as predominant across different healthcare systems. Despite differences in care structure and delivery, the models shared similar organizational components, including coordination and continuity of follow-up, risk-factor management, medication management, and support for lifestyle modification. These components may inform the development of secondary prevention models adapted to the specific characteristics of individual healthcare systems.