The following is a summary of “Remote assessment of cardiac patients post-ACS,” published in the June 2024 issue of Cardiology by Alshahrani et al.

Remote monitoring services, including 12-lead electrocardiogram (ECG) and vital sign data, are being studied to see how they affect the risk of readmission after acute coronary syndrome (ACS). 

Researchers conducted a prospective study to determine whether a patient-initiated remote monitoring service, with ECG, vital signs, and clinical review support, reduces readmission risk post-ACS. 

They enrolled patients with ≥1 cardiovascular risk factor who had ACS and randomly assigned them (1:1) before discharge. The primary endpoint was readmission within 6 months. Secondary endpoints tracked ED visits, major adverse cardiovascular events (MACE), and patient-reported symptoms. The primary analysis was performed according to the intention to treat. Survival analysis using a Cox proportional hazard model and Kaplan-Meier estimator was used for the primary endpoint of time to readmission and the secondary endpoint of ED attendance. 

The results showed that 337 patients were randomized between January 2022 and April 2023, with a low 3.6% dropout rate. The telemedicine group had significantly lower rates of readmission over 6 months (HR =0.24, 95% CI 0.13-0.44, P<0.001) and ED visits (HR=0.59, 95% CI 0.40-0.89). Unplanned coronary revascularizations were also fewer (3% in the telemedicine arm vs. 9% in standard therapy). Symptoms like chest pain (9% vs. 24%), breathlessness (21% vs. 39%), and dizziness (6% vs. 18%) were less common in the telemedicine group at 6 months. 

Investigators concluded that using telemedicine to manage patients after ACS reduced hospital readmissions, ED visits, unplanned coronary procedures, and patient-reported symptoms, highlighting its effectiveness in post-ACS care.

Source: acc.org/Latest-in-Cardiology/Journal-Scans/2024/06/14/15/18/randomized-trial-of-remote