Mobile application and digital system for patients after myocardial infarction: early results from a randomized trial

INTRODUCTION Cardiac rehabilitation (CR) is a complex program aimed at better control of cardiovascular risk factors. It can be supported by mobile applications. Despite promising results from previous studies on telemedicine tools, there is a paucity of evidence when it comes to prospective randomized trials.OBJECTIVES The aim of this study was to comprehensively evaluate 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 A total of 100 patients with myocardial infarction were recruited on admission to the Department of Cardiology at the Medical University of Warsaw. The patients were randomized into the group with an access to the afterAMI application or to the standard CR. Cardiovascular risk factors were analyzed along with the number of rehospitalizations and patient knowledge regarding cardiovascular risk factors. The analysis focused on the results obtained 30 days after discharge.RESULTS Median age of the patients was 61 years (interquartile range, 51-67 years), and 65% of the participants were men. There were no differences in cardiovascular risk factor control between the study groups, apart from low-density lipoprotein cholesterol levels, which were lower in the group using the afterAMI application (P <0.001), despite no differences being found at the beginning of the study. Similarly, a significant difference in N-terminal pro-B-type natriuretic peptide levels was observed after 30 days (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.