Estimation of the efficacy and safety of using the system of remote monitoring of patients after myocardial infarction
DOI: https://dx.doi.org/10.18565/therapy.2021.7.95-103
Pereverzeva K.G., Yakushin S.S.
Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia
Abstract. The aim is to create and estimate the possibility of use, efficacy and safety of system for remote monitoring of health condition of patients after myocardial infarction (MI).
Material and methods. Patients admitted to the hospital for myocardial infarction in the period from 09/01/2018 to 05/01/2019 and survived 12 months after it (n=221) were the subject of the study. They were divided into two groups – experimental and control. The experimental group was provided with a link to a Google questionnaire, which patients had to use when episodes of chest pain and/or shortness of breath appeared. After the performed «pseudorandomization» in the groups, 122 patients were included in the study – 61 person in each group.
Results. From June 2020 to June 2021, adverse events occurred in 18,6% of the studied patients: 7,2% died, 1,8% had MI and coronary artery revascularization (CA) for it, 2 patients (0,9%) had a cerebral stroke, 9,5% underwent coronary artery revascularization due to coronary heart disease progression. After «pseudorandomization» of the groups of patients using and not using the remote control system, statistically significant differences were observed only in the frequency of early CA revascularization: it was performed in 16,4% and 4,9% of cases, respectively (p=0,04).
Conclusion. The results of current work show us, that the use of the developed and tested system of remote monitoring of the condition of patients who have undergone myocardial infarction, in comparison with routine monitoring of such patients on an outpatient basis, provides similar rates of mortality, the incidence of nonfatal MI and cerebral strokes, hospitalizations for progressive angina pectoris, CA revascularization and promotes the earlier use of invasive tactics in the management of patients with acute coronary syndrome without ST-segment elevation.
Keywords: myocardial infarction, telemedicine, remote monitoring, remote monitoring system, revascularization
About the Autors
Kristina G. Pereverzeva, PhD, associate professor of the Department of hospital therapy with a course of medical and social expertise, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390026, Ryazan, 9 Vysokovoltnaya Str. Tel.: +7 (920) 994-55-58. E-mail: pereverzevakg@gmail.com. ORCID: 0000-0001-6141-8994
Sergey S. Yakushin, MD, professor, head of the Department of hospital therapy with a course of medical and social expertise, Academician I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of Russia. Address: 390026, Ryazan, 9 Vysokovoltnaya Str. Tel.: +7 (910) 901-56-39. E-mail: ssyakushin@yandex.ru. ORCID: 0000-0002-1394-3791