Key result
A smartphone-based cardiac rehabilitation program adjunct to usual care improved 6-minute walk test distance compared to usual care alone (Δ117 vs. Δ91 m; P=0.02) at 8 weeks in patients with ACS.
Why the study?
Secondary prevention of coronary heart disease faces treatment gaps with poorly defined strategies for early physical activity after ACS, which smartphone technology might help address.
Does an adjunctive smartphone-based cardiac rehabilitation program improve exercise capacity in patients with acute coronary syndromes?
RCT (n=206)
Yes
Does an adjunctive smartphone-based cardiac rehabilitation program improve exercise capacity in patients with acute coronary syndromes?
Absolute Event Rate: 117% vs 91%
p-value: p=0.02
A smartphone-based cardiac rehabilitation program added to usual care significantly improves 8-week exercise capacity and rehab adherence in patients with acute coronary syndromes.
Supports adjunctive smartphone cardiac rehab in ACS to boost participation; extends RCT evidence for digital secondary prevention.
BACKGROUND: There are well-documented treatment gaps in secondary prevention of coronary heart disease with a lack of clearly defined strategies to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps. OBJECTIVES: The primary goal of this study was to assess whether a smartphone-based, early cardiac rehabilitation program improved exercise capacity in patients with ACS. METHODS: A total of 206 patients with ACS across six tertiary Australian hospitals were included in this randomized controlled trial. Participants were randomized to usual care (UC; including referral to traditional cardiac rehabilitation), with or without an adjunctive smartphone-based cardiac rehabilitation program (S-CRP) upon hospital discharge. The primary endpoint was change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline, between groups. Secondary endpoints included uptake and adherence to cardiac rehabilitation, changes in cardiac risk factors, psychological well-being and quality of life status. RESULTS: Of the 168 patients with complete follow-up (age 56 ± 10 years; 16% females), 83 were in the S-CRP. At 8-week follow-up, the S-CRP group had a clinically significant improvement in 6-minute walk test distance (Δ117 ± 76 vs. Δ91 ± 110 m; P = 0.02). Patients in the S-CRP were more likely to participate (87% vs. 51%, P < 0.001) and adhere (72% vs. 22%, P < 0.001) to a cardiac rehabilitation program. Compared to UC, patients receiving S-CRP had similar smoking cessation rates, LDL-cholesterol levels, blood pressure reduction, depression, anxiety and quality of life measures (all P = NS). CONCLUSION: In patients with ACS, a S-CRP, as an adjunct to UC improved exercise capacity at 8 weeks in addition to participation and adherence to cardiac rehabilitation (Australian New Zealand Clinical Trials Registry; ACTRN12616000426482).
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Yudi et al. (2020) conducted an RCT in acute coronary syndromes (n=206). smartphone-based cardiac rehabilitation program (S-CRP) vs. usual care was evaluated on change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline (p=0.02). A smartphone-based cardiac rehabilitation program adjunct to usual care improved 6-minute walk test distance compared to usual care alone (Δ117 vs. Δ91 m; P=0.02) at 8 weeks in patients with ACS.
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