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Impact of Remote Monitoring on Long‐Term Prognosis in Heart Failure Patients in a Real‐World Cohort: Results From All‐Comers COMMIT‐HF Trial
Author(s) -
KUREK ANNA,
TAJSTRA MATEUSZ,
GADULAGACEK ELZBIETA,
BUCHTA PIOTR,
SKRZYPEK MICHAL,
PYKA LUKASZ,
WASIAK MICHAL,
SWIETLINSKA MALGORZATA,
HAWRANEK MICHAL,
POLONSKI LECH,
GASIOR MARIUSZ,
KOSIUK JEDRZEJ
Publication year - 2017
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13174
Subject(s) - medicine , cardiac resynchronization therapy , hazard ratio , heart failure , cohort , confidence interval , clinical endpoint , population , randomized controlled trial , implantable cardioverter defibrillator , cohort study , observational study , cardiology , emergency medicine , ejection fraction , environmental health
Remote Monitoring in Real‐World Cohort Background Randomized controlled trials demonstrate that remote monitoring (RM) of implantable cardioverter–defibrillators (ICDs) and cardiac resynchronization therapy devices (CRT‐Ds) may improve quality of care and prognosis in heart failure (HF) patients. However, the impact of RM on long‐term mortality in a real‐world cohort is still not well examined. Methods and Results This study was designed as a matched cohort study based on the COMMIT‐HF trial––a single‐center, ongoing prospective observational registry (NCT02536443). Complete patient demographics, medical history, in‐hospital results, hospitalizations, and mortality data were collected based on institutional registries and healthcare providers’ records. Patients were divided into 2 groups based on RM presence and matched by means of propensity scores according to clinical characteristics. The primary endpoint of this study was the long‐term all‐cause mortality. Out of 1,429 consecutive patients, 822 patients with a first implantation of an ICD/CRT‐D were included in the analysis. The final matched study population contained 574 patients in RM and in a control group. Although demographic and echocardiographic parameters as well as pharmacological treatments were similar in both groups, a significantly lower 1‐year mortality was detected in the RM group (2.1% vs. 11.5%, P < 0.0001). This was also maintained during a 3‐year follow‐up (4.9% vs. 22.3%, P < 0.0001). Multivariate analysis showed that RM was associated with an improved prognosis (hazard ratio 0.187, 95% confidence interval 0.075–0.467, P = 0.0003). Conclusion RM of HF patients with ICDs/CRT‐Ds significantly reduced long‐term mortality in a real‐world clinical condition.