Abstract 11358: Participation in a Telemedicine Program Improves Modifiable Cardiac Risk Factors in Patients after Acute Coronary Syndrome Long Term
Background: Following acute coronary syndrome (ACS), patients are at increased risk of another cardiovascular event. Progression of coronary artery disease is accelerated by modifiable cardiac risk factors (CRF). Identifying and modifying these CRFs may help decrease the chance for recurrent events. Usual care programs have not proven efficacy in modifying CRFs over long periods in large groups of patients. The goal of this study was to determine if long-term enrollment in a telemedicine program can improve and maintain CRFs over time when compared to usual care.
Methods: We enrolled 110 patients post ACS into our telemedicine program (TMP), and 110 patients receiving usual clinical care were used as control. The TMP is designed to increase the patient's knowledge of ACS and encourage self-management of CRFs. Patients use a one-way phone-based telecommunication device for daily reporting of vital signs and symptoms, it also reminds them of drug compliance and provides education on CRFs. Care Coordinators follow the reported data and facilitate access to timely medication adjustments and medical services.
Results: Baseline characteristics were similar between both groups except systolic BP (SBP), 125.5 vs. 131.8 mmHg (p<0.05) and glucose, 115.6 vs. 137.5mg/dL (p<0.05) for TMP vs. control. The control group showed no significant differences in CRFs between baseline and at 24 months. The TMP had significantly reduced SBP and DBP, 125.5 to 119.7 mmHg (p<0.05) and 69.8 to 66.5 mmHg (p<0.05); heart rate, 71.8 to 67 bpm (p<0.001); cholesterol, 156.2 to 144.5 mg/dL (p<0.05); and LDL, 83.0 to 72.9 mg/dL (p<0.05), after 24 months of participation. Comparing TMP and control group at 24 months, there was a significant difference for SBP, 119.7 vs. 132.3 mmHg (p<0.001), DBP, 66.5 vs. 71.7 mmHg (p<0.001), heart rate, 67 vs. 71.3 bpm (p<0.05), and cholesterol, 144.5 vs. 159.9 mg/dL (p<0.05), respectively.
Conclusions: For patients after ACS, participation in our TMP for 24 months significantly improved and maintained modifiable CRFs compared with baseline and with usual care.
- © 2011 by American Heart Association, Inc.