B67-07 Remote Pulmonary Artery Pressure Monitoring and Outcomes in Primary PH: A Comparative Study of Mortality and Readmission

Introduction Pulmonary hypertension (PH) may lead to right ventricular dysfunction, heart failure, and increased morbidity and mortality. Frequent and accurate assessment of hemodynamics is critical for optimizing management. The CardioMEMS HF System, a wireless implantable sensor, enables remote, ambulatory monitoring of pulmonary artery pressures that has shown to be safe and effective reducing pulmonary artery pressures and improving functional status in patients with PH, including those with advanced right-sided heart failure1-2. However, there is limited data regarding its use in patients with primary PH (WHO class I). Methods This was a retrospective multicenter cohort study designed to evaluate the impact of remote pulmonary artery monitoring device (CardioMEMS) in 30-day readmissions and MACE in patients with primary pulmonary hypertension using data from the TrinetX database. Subjects were identified using ICD code I27.0 (primary PH) and CPT code 93264 for remote monitoring of pulmonary artery pressure. All patients > 18 years old with a diagnosis of primary PH were included. Primary outcome was 6-month all-cause readmissions. Secondary outcome was MACE events at 6 months, defined as stroke, myocardial infarction or mortality. We performed a 1:1 propensity score matching (PSM) based on age, sex, comorbidities, BNP, and Left Ventricular Ejection Fraction (LVEF) using the nearest neighbor method and using a caliper of 0.1. Baseline characteristics before and after matching were compared using Chi-Square test for binary variables and T-test for continuous variables. We then performed a Kaplan-Meier analysis to evaluate the primary and secondary outcomes. Results We identified 132,730 patients with PH WHO class I. 155 Had a CardioMEMS device. 140 patient were assigned to each group after matching propensity scores. The mean age of the matched CardioMEMS population was 66.7 ± 14 and 68.5 ± 12.9 in the matched non-CardioMEMS group. 6-month readmission rates were lower in the matched CardioMEMS population (HR 0.657, 0.466-0.925, p 0.015). Less hospitalizations were seen in the CardioMEMS group (mean of 7.06 ± 7.091, median 5.5) compared to the non cardioMEMS group (mean of 8.653 ± 14.002, median 4) in the follow-up period. Finally, the cardioMEMS group had lower rates of MACE (HR 0.463, 0.279-0.769, p 0.002). Conclusions In this observational, retrospective study, patients with Primary PH managed with CardioMEMS had lower rates of hospitalization and MACE. Despite using PSM to mitigate confounders, residual confounding from unmeasured variables persists. Furthermore, the selection of patients for a remote monitoring device inherently introduces potential selection bias.