Mobile app and digital system for patients after Myocardial Infarction (afterAMI): early results from a randomized trial

Abstract

Introduction: Cardiac rehabilitation is a complex program which aims to better control a patient’s cardiovascular risk factors. It can be supported by mobile applications. Despite promising results from previous studies with telemedicine tools, there is a paucity of evidence when it comes to prospective randomized trials.

Objectives: The aim was to perform a comprehensive evaluation of a newly developed mobile application – called afterAMI – in the clinical setting and to assess the impact of the application-supported model of care in comparison with standard rehabilitation.

Patients and methods: 100 patients with myocardial infarction were recruited on admission to the Department of Cardiology at Medical University of Warsaw. Patients were randomized into group with an access to afterAMI app or to standard cardiac rehabilitation. Cardiovascular risk factors were analyzed along with the number of rehospitalizations and patients’ knowledge regarding cardiovascular risk factors. This analysis focused on the results 30 days after discharge.

Results: The patients’ median age was 61 years and 65% of the subjects were male. There were no differences in cardiovascular risk factor control between the study groups apart from LDL cholesterol levels, which were lower in the “afterAMI” group (P<0.001), despite no differences being found at the beginning of the study. Similarly, a significant difference in NT-proBNP levels was observed (P=0.02), despite a lack of significant differences at randomization.

Conclusions: This study serves as an example of a telemedicine tool being implemented into everyday practice. The augmented rehabilitation program resulted in better control of cholesterol level. Longer follow-up is required to establish prognosis in this population.