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A Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohort

2017-03Journal article Open access
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dc.contributor.authorPortugal, G
dc.contributor.authorCunha, PS
dc.contributor.authorValente, B
dc.contributor.authorFeliciano, J
dc.contributor.authorLousinha, A
dc.contributor.authorAlves, S
dc.contributor.authorBraz, M
dc.contributor.authorPimenta, R
dc.contributor.authorDelgado, AS
dc.contributor.authorOliveira, MM
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2017-05-24T15:35:41Z
dc.date.available2017-05-24T15:35:41Z
dc.date.issued2017-03
dc.description.abstractAIMS: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2017 Mar;36(3):189-195pt_PT
dc.identifier.doi10.1016/j.repc.2016.08.009pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2691
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Cardiologiapt_PT
dc.subjectHSM CARpt_PT
dc.subjectCohort Studiespt_PT
dc.subjectDeath, Sudden, Cardiac/prevention & controlpt_PT
dc.subjectDefibrillators, Implantable/adverse effectspt_PT
dc.subjectDefibrillators, Implantable/standards
dc.subjectPatient Admission/statistics & numerical data
dc.subjectPropensity Score
dc.subjectQuality Improvement
dc.subjectRemote Sensing Technology
dc.subjectRetrospective Studies
dc.subjectTime Factors
dc.titleA Link to Better Care: The Effect of Remote Monitoring on Long-Term Adverse Cardiac Events in a Propensity Score-Matched Cohortpt_PT
dc.title.alternativeO Efeito da Monitorização Remota em Eventos Cardíacos Adversos numa Amostra Emparelhada por Propensity-Score Matchingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage195pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage189pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume36pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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