A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2691 |
Resumo: | AIMS: There are conflicting data regarding the clinical benefits of device-based remote monitoring (RM). We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICDs). METHODS: We assessed the incidence of adverse cardiac events, overall mortality and device therapy efficacy and safety in a propensity score-matched cohort of patients under RM compared to patients under conventional follow-up. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. The primary outcome was time to a composite outcome of first hospital admission for heart failure or cardiovascular death. RESULTS: Of a total of 923 implantable device recipients, 164 matched patients were identified (84 under RM, 84 under conventional follow-up). The mean follow-up was 44 months (range 1-123). There were no significant differences regarding baseline characteristics in the matched cohorts. Patients under RM had a significantly lower incidence of the primary outcome (hazard ratio [HR] 0.42, confidence interval [CI] 0.20-0.88, p=0.022); there was a non-significant trend towards lower overall mortality (HR 0.53, CI 0.27-1.04, p=0.066). No significant differences between cohorts were found regarding appropriate therapies (RM vs. conventional follow-up, 8.1 vs. 8.2%, p=NS) or inappropriate therapies (6.8 vs. 5.0%, p=NS). CONCLUSION: In a propensity score-matched cohort of ICD recipients with long-term follow-up, RM was associated with a lower rate of a combined endpoint of hospital admission for heart failure or cardiovascular death. |
id |
RCAP_0da2588f65c23c51109b1c015bbddbbe |
---|---|
oai_identifier_str |
oai:repositorio.chlc.min-saude.pt:10400.17/2691 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched CohortO Efeito da Monitorização Remota em Eventos Cardíacos Adversos numa Amostra Emparelhada por Propensity-Score MatchingHSM CARCohort StudiesDeath, Sudden, Cardiac/prevention & controlDefibrillators, Implantable/adverse effectsDefibrillators, Implantable/standardsPatient Admission/statistics & numerical dataPropensity ScoreQuality ImprovementRemote Sensing TechnologyRetrospective StudiesTime FactorsAIMS: There are conflicting data regarding the clinical benefits of device-based remote monitoring (RM). We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICDs). METHODS: We assessed the incidence of adverse cardiac events, overall mortality and device therapy efficacy and safety in a propensity score-matched cohort of patients under RM compared to patients under conventional follow-up. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. The primary outcome was time to a composite outcome of first hospital admission for heart failure or cardiovascular death. RESULTS: Of a total of 923 implantable device recipients, 164 matched patients were identified (84 under RM, 84 under conventional follow-up). The mean follow-up was 44 months (range 1-123). There were no significant differences regarding baseline characteristics in the matched cohorts. Patients under RM had a significantly lower incidence of the primary outcome (hazard ratio [HR] 0.42, confidence interval [CI] 0.20-0.88, p=0.022); there was a non-significant trend towards lower overall mortality (HR 0.53, CI 0.27-1.04, p=0.066). No significant differences between cohorts were found regarding appropriate therapies (RM vs. conventional follow-up, 8.1 vs. 8.2%, p=NS) or inappropriate therapies (6.8 vs. 5.0%, p=NS). CONCLUSION: In a propensity score-matched cohort of ICD recipients with long-term follow-up, RM was associated with a lower rate of a combined endpoint of hospital admission for heart failure or cardiovascular death.Sociedade Portuguesa de CardiologiaRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEPortugal, GCunha, PSValente, BFeliciano, JLousinha, AAlves, SBraz, MPimenta, RDelgado, ASOliveira, MMCruz Ferreira, R2017-05-24T15:35:41Z2017-032017-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2691engRev Port Cardiol. 2017 Mar;36(3):189-19510.1016/j.repc.2016.08.009info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:39:09Zoai:repositorio.chlc.min-saude.pt:10400.17/2691Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:01.740165Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort O Efeito da Monitorização Remota em Eventos Cardíacos Adversos numa Amostra Emparelhada por Propensity-Score Matching |
title |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
spellingShingle |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort Portugal, G HSM CAR Cohort Studies Death, Sudden, Cardiac/prevention & control Defibrillators, Implantable/adverse effects Defibrillators, Implantable/standards Patient Admission/statistics & numerical data Propensity Score Quality Improvement Remote Sensing Technology Retrospective Studies Time Factors |
title_short |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
title_full |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
title_fullStr |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
title_full_unstemmed |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
title_sort |
A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort |
author |
Portugal, G |
author_facet |
Portugal, G Cunha, PS Valente, B Feliciano, J Lousinha, A Alves, S Braz, M Pimenta, R Delgado, AS Oliveira, MM Cruz Ferreira, R |
author_role |
author |
author2 |
Cunha, PS Valente, B Feliciano, J Lousinha, A Alves, S Braz, M Pimenta, R Delgado, AS Oliveira, MM Cruz Ferreira, R |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Portugal, G Cunha, PS Valente, B Feliciano, J Lousinha, A Alves, S Braz, M Pimenta, R Delgado, AS Oliveira, MM Cruz Ferreira, R |
dc.subject.por.fl_str_mv |
HSM CAR Cohort Studies Death, Sudden, Cardiac/prevention & control Defibrillators, Implantable/adverse effects Defibrillators, Implantable/standards Patient Admission/statistics & numerical data Propensity Score Quality Improvement Remote Sensing Technology Retrospective Studies Time Factors |
topic |
HSM CAR Cohort Studies Death, Sudden, Cardiac/prevention & control Defibrillators, Implantable/adverse effects Defibrillators, Implantable/standards Patient Admission/statistics & numerical data Propensity Score Quality Improvement Remote Sensing Technology Retrospective Studies Time Factors |
description |
AIMS: There are conflicting data regarding the clinical benefits of device-based remote monitoring (RM). We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICDs). METHODS: We assessed the incidence of adverse cardiac events, overall mortality and device therapy efficacy and safety in a propensity score-matched cohort of patients under RM compared to patients under conventional follow-up. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. The primary outcome was time to a composite outcome of first hospital admission for heart failure or cardiovascular death. RESULTS: Of a total of 923 implantable device recipients, 164 matched patients were identified (84 under RM, 84 under conventional follow-up). The mean follow-up was 44 months (range 1-123). There were no significant differences regarding baseline characteristics in the matched cohorts. Patients under RM had a significantly lower incidence of the primary outcome (hazard ratio [HR] 0.42, confidence interval [CI] 0.20-0.88, p=0.022); there was a non-significant trend towards lower overall mortality (HR 0.53, CI 0.27-1.04, p=0.066). No significant differences between cohorts were found regarding appropriate therapies (RM vs. conventional follow-up, 8.1 vs. 8.2%, p=NS) or inappropriate therapies (6.8 vs. 5.0%, p=NS). CONCLUSION: In a propensity score-matched cohort of ICD recipients with long-term follow-up, RM was associated with a lower rate of a combined endpoint of hospital admission for heart failure or cardiovascular death. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-05-24T15:35:41Z 2017-03 2017-03-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2691 |
url |
http://hdl.handle.net/10400.17/2691 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rev Port Cardiol. 2017 Mar;36(3):189-195 10.1016/j.repc.2016.08.009 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cardiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799131296949075968 |