Telemedicine works well in patients with acute coronary syndrome

Remote assessment appears effective in reducing hospital readmission, emergency department (ED) visits, unplanned revascularization, and patient-reported symptoms following an acute coronary syndrome (ACS), reports a study.

From January 2022 to April 2023, researchers randomized 337 patients presenting with ACS and at least one cardiovascular risk factor in a 1:1 ratio to receive either a telemedicine-based approach or standard care prior to discharge. Participants had a mean age of 58.1 years, with a dropout rate of 3.6 percent.

Time to first readmission at 6 months was the primary outcome, while ED visits, major adverse cardiovascular events, and patient-reported symptoms were secondary. An intention-to-treat analysis was performed in all participants.

At 6 months, readmission rates (hazard ratio [HR], 0.24, 95 percent confidence interval [CI], 0.13‒0.44; p<0.001) and ED attendance (HR, 0.59, 95 percent CI, 0.40‒0.89) decreased in the telemedicine arm. Unplanned coronary revascularizations were also fewer in patients receiving telemedicine compared with those receiving standard therapy (3 percent vs 9 percent).

Furthermore, the telemedicine group reported lower incidences of chest pain (9 percent vs 24 percent), breathlessness (21 percent vs 39 percent), and dizziness (6 percent vs 18 percent) at month 6.

This 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,” researchers said.