Effectiveness of digital healthcare to improve clinical outcomes in discharged patients with coronary artery disease

IF 15.1 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

NPJ Digital Medicine Pub Date : 2025-07-23 DOI:10.1038/s41746-025-01655-6

Lanshu Yang, Zuoxiang Wang, Sheng Zhao, Mengyuan Liu, Yalin Zhu, Fenghuan Hu, Xiaojin Gao, Yongjian Wu

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Abstract

Post-discharge management of coronary artery disease (CAD) remains clinically challenging, with digital healthcare’s efficacy underexplored. This study analyzed 16,797 CAD patients enrolled in the HeartMed Digital Management System (June 2018–September 2022), comparing outcomes between a digital management (DM, n = 4,713) and conventional management (CM, n = 12,084) cohort over 12 months. Cox models adjusted for confounders revealed significantly reduced all-cause mortality in the DM group (1.6% vs. 2.7%; HR 0.58, 95% CI 0.45–0.75, p < 0.001) and lower risks for major adverse cardiovascular events (MACCE: 6.4% vs. 9.2%; HR 0.67, 0.59–0.77, p < 0.001), cardiovascular death (HR 0.70, 0.51–0.95), myocardial infarction (HR 0.38, 0.29–0.50), recurrent angina (HR 0.75, 0.65–0.87), revascularization (HR 0.84, 0.71–0.99), and readmissions (HR 0.76, 0.68–0.84) (p < 0.05 for all). Digital healthcare demonstrates superior post-discharge optimization of CAD outcomes, significantly attenuating mortality and morbidity.

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数字医疗对改善冠状动脉疾病出院患者临床结果的有效性

冠状动脉疾病（CAD）的出院后管理在临床上仍然具有挑战性，数字医疗保健的功效尚未得到充分探索。本研究分析了在HeartMed数字管理系统（2018年6月至2022年9月）登记的16,797例CAD患者，比较了数字管理（DM, n = 4,713）和传统管理（CM, n = 12,084）队列在12个月内的结果。校正混杂因素的Cox模型显示，糖尿病组的全因死亡率显著降低(1.6% vs. 2.7%；HR 0.58, 95% CI 0.45-0.75, p < 0.001)和较低的主要不良心血管事件风险(MACCE: 6.4% vs. 9.2%；HR 0.67, 0.59-0.77, p < 0.001)，心血管死亡（HR 0.70, 0.51-0.95），心肌梗死（HR 0.38, 0.29-0.50），心绞痛复发（HR 0.75, 0.65-0.87），血运重建（HR 0.84, 0.71-0.99），再入院（HR 0.76, 0.68-0.84）（p < 0.05）。数字医疗显示了优越的出院后CAD结果优化，显著降低了死亡率和发病率。

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来源期刊

NPJ Digital Medicine Multiple-

CiteScore

25.10

自引率

3.30%

发文量

170

审稿时长

15 weeks

期刊介绍： npj Digital Medicine is an online open-access journal that focuses on publishing peer-reviewed research in the field of digital medicine. The journal covers various aspects of digital medicine, including the application and implementation of digital and mobile technologies in clinical settings, virtual healthcare, and the use of artificial intelligence and informatics. The primary goal of the journal is to support innovation and the advancement of healthcare through the integration of new digital and mobile technologies. When determining if a manuscript is suitable for publication, the journal considers four important criteria: novelty, clinical relevance, scientific rigor, and digital innovation.