Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome
Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post–acute coronary syndrome (ACS). TELE-ACS (Remote Acute Assessment of Patients With High Cardiovascular Risk Post-Acute Coronary Syndrome) is a rand...
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Published in | Journal of the American College of Cardiology Vol. 83; no. 23; pp. 2250 - 2259 |
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Main Authors | , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
11.06.2024
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Abstract | Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post–acute coronary syndrome (ACS).
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.
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.
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.
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)
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AbstractList | Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post-acute coronary syndrome (ACS).BACKGROUNDTelemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post-acute coronary syndrome (ACS).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.OBJECTIVESTELE-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.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.METHODSPatients 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.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.RESULTSA 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.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).CONCLUSIONSThe 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). Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post-acute coronary syndrome (ACS). 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. 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. 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. 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). Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post–acute coronary syndrome (ACS). 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. 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. 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. 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) [Display omitted] |
Author | Hajhosseiny, Reza Akbari, Tamim Bassett, Paul Khawaja, Saud Howard, James Kaura, Amit Hartley, Adam Francis, Darrel Seligman, Henry Khamis, Ramzi Alharbi, Badr A. Al-Lamee, Rasha Kelshiker, Mihir A. Peters, Nicholas S. Alshahrani, Nasser S. |
Author_xml | – sequence: 1 givenname: Nasser S. orcidid: 0000-0003-2752-6988 surname: Alshahrani fullname: Alshahrani, Nasser S. organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 2 givenname: Adam surname: Hartley fullname: Hartley, Adam organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 3 givenname: James surname: Howard fullname: Howard, James organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 4 givenname: Reza surname: Hajhosseiny fullname: Hajhosseiny, Reza organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 5 givenname: Saud surname: Khawaja fullname: Khawaja, Saud organization: Imperial College Healthcare NHS Trust, London, United Kingdom – sequence: 6 givenname: Henry surname: Seligman fullname: Seligman, Henry organization: Imperial College Healthcare NHS Trust, London, United Kingdom – sequence: 7 givenname: Tamim surname: Akbari fullname: Akbari, Tamim organization: Imperial College Healthcare NHS Trust, London, United Kingdom – sequence: 8 givenname: Badr A. surname: Alharbi fullname: Alharbi, Badr A. organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 9 givenname: Paul surname: Bassett fullname: Bassett, Paul organization: Statsconsultancy Ltd, Amersham, Buckinghamshire, United Kingdom – sequence: 10 givenname: Rasha surname: Al-Lamee fullname: Al-Lamee, Rasha organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 11 givenname: Darrel surname: Francis fullname: Francis, Darrel organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 12 givenname: Amit surname: Kaura fullname: Kaura, Amit organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 13 givenname: Mihir A. surname: Kelshiker fullname: Kelshiker, Mihir A. organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 14 givenname: Nicholas S. surname: Peters fullname: Peters, Nicholas S. organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom – sequence: 15 givenname: Ramzi surname: Khamis fullname: Khamis, Ramzi email: r.khamis@imperial.ac.uk organization: National Heart and Lung Institute, Imperial College London, London, United Kingdom |
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Keywords | telemedicine ACS acute coronary syndrome myocardial infarction rehospitalization ECG remote monitoring |
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Snippet | Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post–acute... Telemedicine programs can provide remote diagnostic information to aid clinical decisions that could optimize care and reduce unplanned readmissions post-acute... |
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SubjectTerms | acute coronary syndrome Acute Coronary Syndrome - diagnosis Acute Coronary Syndrome - therapy Aged Emergency Service, Hospital Female Humans Male Middle Aged myocardial infarction Patient Readmission - statistics & numerical data rehospitalization remote monitoring Telemedicine |
Title | Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome |
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