دورية أكاديمية
Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome.
| العنوان: | Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome. |
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| المؤلفون: | Alshahrani NS; National Heart and Lung Institute, Imperial College London, London, United Kingdom; King Khalid University, Abha, Saudi Arabia., Hartley A; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Howard J; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Hajhosseiny R; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Khawaja S; Imperial College Healthcare NHS Trust, London, United Kingdom., Seligman H; Imperial College Healthcare NHS Trust, London, United Kingdom., Akbari T; Imperial College Healthcare NHS Trust, London, United Kingdom., Alharbi BA; National Heart and Lung Institute, Imperial College London, London, United Kingdom; King Khalid University, Abha, Saudi Arabia., Bassett P; Statsconsultancy Ltd, Amersham, Buckinghamshire, United Kingdom., Al-Lamee R; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Francis D; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Kaura A; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Kelshiker MA; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Peters NS; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom., Khamis R; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom. Electronic address: r.khamis@imperial.ac.uk. |
| المصدر: | Journal of the American College of Cardiology [J Am Coll Cardiol] 2024 Jun 11; Vol. 83 (23), pp. 2250-2259. Date of Electronic Publication: 2024 Apr 06. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983- |
| مواضيع طبية MeSH: | Acute Coronary Syndrome*/therapy , Acute Coronary Syndrome*/diagnosis , Telemedicine* , Patient Readmission*/statistics & numerical data, Humans ; Male ; Female ; Middle Aged ; Aged ; Emergency Service, Hospital |
| مستخلص: | 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 (1:1) 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). Competing Interests: Funding Support and Author Disclosures This work was funded by the British Heart Foundation; King Khalid University, Abha, Saudi Arabia via The Saudi Arabian Cultural Bureau (SACB); Sansour Fund, Imperial Healthcare Charity; and the Safwan Sobhan Fund at Imperial College London. TELE-ACS was an investigator-initiated trial sponsored by Imperial College London. All authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: acute coronary syndrome; myocardial infarction; rehospitalization; remote monitoring; telemedicine |
| سلسلة جزيئية: | ClinicalTrials.gov NCT05015634 |
| تواريخ الأحداث: | Date Created: 20240408 Date Completed: 20240605 Latest Revision: 20240819 |
| رمز التحديث: | 20240820 |
| DOI: | 10.1016/j.jacc.2024.03.398 |
| PMID: | 38588928 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1558-3597 |
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| DOI: | 10.1016/j.jacc.2024.03.398 |