Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome.
J Am Coll Cardiol
; 83(23): 2250-2259, 2024 Jun 11.
Article
em En
| MEDLINE
| ID: mdl-38588928
ABSTRACT
BACKGROUND:
Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post-acute coronary syndrome (ACS).OBJECTIVES:
TELE-ACS (Remote Acute Assessment of Patients With High Cardiovascular Risk Post-Acute Coronary Syndrome) is a randomized controlled trial that aims to compare a telemedicine-based approach vs standard care in patients following ACS.METHODS:
Patients were suitable for inclusion with at least 1 cardiovascular risk factor and presenting with ACS and were randomized (11) before discharge. The primary outcome was time to first readmission at 6 months. Secondary outcomes included emergency department (ED) visits, major adverse cardiovascular events, and patient-reported symptoms. The primary analysis was performed according to intention to treat.RESULTS:
A total of 337 patients were randomized from January 2022 to April 2023, with a 3.6% drop-out rate. The mean age was 58.1 years. There was a reduced rate of readmission over 6 months (HR 0.24; 95% CI 0.13-0.44; P < 0.001) and ED attendance (HR 0.59; 95% CI 0.40-0.89) in the telemedicine arm, and fewer unplanned coronary revascularizations (3% in telemedicine arm vs 9% in standard therapy arm). The occurrence of chest pain (9% vs 24%), breathlessness (21% vs 39%), and dizziness (6% vs 18%) at 6 months was lower in the telemedicine group.CONCLUSIONS:
The TELE-ACS study has shown that a telemedicine-based approach for the management of patients following ACS was associated with a reduction in hospital readmission, ED visits, unplanned coronary revascularization, and patient-reported symptoms. (Telemedicine in High-Risk Cardiovascular Patients Post-ACS [TELE-ACS]; NCT05015634).Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
/
Telemedicina
/
Síndrome Coronariana Aguda
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2024
Tipo de documento:
Article