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A. Basics
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01. History of Cardiology
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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Clinical impact of non-invasive telemonitoring in patients with chronic heart failure
Session:
Painel 2 - Insuficiência Cardíaca 8
Speaker:
Afonso Nunes Ferreira
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Afonso Nunes Ferreira; João Pedro Ribeiro Agostinho; Joana Rigueira; Inês Aguiar Ricardo; Rafael Santos; Tiago Graça Rodrigues; Nelson P. Cunha; Pedro Silvério António; Sara Couto Pereira; Pedro Morais; Joana Brito; Maria Mónica Mendes Pedro; Fátima Veiga; Fausto José Pinto; Dulce Brito
Abstract
<p>Introduction:<br /> Impact on prognosis and quality of life of non-invasive remote monitoring of patients with heart failure (HF) is controversial, mainly when compared to a protocol-based HF program.</p> <p>Objectives: <br /> To assess the success and the impact in the quality of life of HF patients followed-up in a telemonitoring (TM) program versus a protocol-based follow-up program (PFP).</p> <p>Methods: <br /> Prospective and single center study of propensity score matched patients (pts) discharged from hospital after an episode of decompensated HF. Pts were matched according to age, NYHA at discharge and ejection fraction (EF): 1 group of 50 pts integrated in a PFP after hospital discharge, and 1 group of 25 pts integrated in a TM program. <br /> The TM group included patients with HF and reduced EF and ≥1 HF hospitalization last year. These pts were evaluated remotely 24/7.<br /> 12-month success was assessed by composed endpoint (death or hospitalization from any cause) with Kaplan-Meier analysis, and by the days lost due to unplanned hospital admission, evaluated by hospital emergency department admission, total number of days hospitalized or death.<br /> Quality of life (QoL) was evaluated by NTproBNP, NYHA and Kansas City Cardiomyopathy Questionnaire (KCCQ).</p> <p>Results:<br /> Mean age of patients was 66.8 ± 10.6 years, 28% female. Dilated cardiomyopathy was the main etiology in 53.3%. Median EF at baseline was 26% (20-32), NTproBNP of 3293±3542pg/mL. There were no significant differences in the baseline clinical and laboratory characteristics of patients.<br /> In the 12-month success evaluation, there was no difference between TM or PFP in death or all-cause hospitalization (HR 0.54, p=0.2). However, there was a reduction in the average of days lost due to unplanned hospital admissions or all-cause death in the TM group compared to PFP group (5.6 vs 12.4 days, p<0.05).<br /> In QoL, there was a more significant reduction in the mean NTproBNP in TM group from 3112±2456pg/ml to 1655±1670pg/mL (p<0.05) than in the PFP group from 3394±4043pg/ml to 3183±3183±7170pg/mL.<br /> 52.2% of patients on TM group had an improvement at 12 months in NYHA functional class, compared with 32% in the PFP group. The mean decrease in total symptom score in KCCQ (indicating fewer symptoms) was greater in the TM vs PFP (19.9±26.2 vs 13.5±21.1). Fewer had deterioration (5.3% vs 17.9%).</p> <p>Conclusions:<br /> TM program when compared to a PFP program may decrease the number of days lost due to hospital admission or death, with an improvement in the quality of life.</p>
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