scholarly journals REMOTE PATIENT MONITORING FOR PREDICTING MAJOR ADVERSE CARDIAC EVENTS (MACE) AND CARDIOVASCULAR HOSPITALIZATIONS IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE (SIHD): A REPORT FROM THE PREDICTION, RISK, AND EVALUATION OF MAJOR ADVERSE CARDIAC EVENTS (PRE-MACE) STUDY

2021 ◽  
Vol 77 (18) ◽  
pp. 3251
Author(s):  
Benita Tjoe ◽  
Gillian Gresham ◽  
Sandy Joung ◽  
Corey Arnold ◽  
Shivani Dhawan ◽  
...  
2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Chrisandra L. Shufelt ◽  
Andy Kim ◽  
Sandy Joung ◽  
Lili Barsky ◽  
Corey Arnold ◽  
...  

Background Patients with stable ischemic heart disease represent a heterogeneous population at variable risk for major adverse cardiac events (MACE). Because MACE typically occurs outside the hospital, we studied whether biometric and psychometric remote patient monitoring are associated with MACE risk biomarkers. Methods and Results In 198 patients with stable ischemic heart disease (mean age 65±11 years, 60% women), we evaluated baseline measures, including biometric (FitBit 2) and psychometric (acquired via smartphone‐administered patient‐reported outcomes) remote monitoring, in the PRE‐MACE (Prediction, Risk, and Evaluation of Major Adverse Cardiac Events) study. In multivariable adjusted regression analyses, we examined the association of these measures with biomarkers of MACE risk, including NT‐proBNP (N‐terminal pro‐b‐type natriuretic peptide), u‐hs‐cTnI (ultra‐high sensitivity cardiac‐specific troponin I), and hs‐CRP (high‐sensitivity C‐reactive) protein. Both biometric and psychometric measures were associated with NT‐proBNP. Specifically, step count, heart rate, physical activity, global health score, and physical function score were all inversely related, whereas physical limitation score was directly related ( P ≤0.05 for all). However, only biometric measures (step count and heart rate) were associated with u‐hs‐cTnI (inversely related, P <0.05), while only the psychometric measures of physical limitation were associated with hs‐CRP (directly related, P ≤0.05). Conclusions In stable ischemic heart disease patients, remotely monitored measures were associated with MACE risk biomarkers. Both biometric and psychometric measures were related to NT‐proBNP. In contrast, biometric measures were uniquely related to u‐hs‐cTnI, while psychometric indices were uniquely related to hs‐CRP. Further investigation could assess the predictive value of these metrics for MACE in ischemic heart disease.


2020 ◽  
Vol 105 (8) ◽  
pp. 2830-2845
Author(s):  
Chun-Yu Chang ◽  
Yung-Jiun Chien ◽  
Po-Chen Lin ◽  
Chien-Sheng Chen ◽  
Meng-Yu Wu

Abstract Context The association of non-thyroidal illness syndrome (NTIS) and hypothyroidism with the prognosis in ischemic heart disease (IHD) population is inconclusive. Objective We aimed to evaluate the influence of NTIS and hypothyroidism on all-cause mortality and major adverse cardiac events (MACE) in IHD population. Data Sources We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from inception through February 17, 2020. Study Selection Original articles enrolling IHD patients, comparing all-cause mortality and MACE of NTIS and hypothyroidism with those of euthyroidism, and providing sufficient information for meta-analysis were considered eligible. Data Extraction Relevant information and numerical data were extracted for methodological assessment and meta-analysis. Data Synthesis Twenty-three studies were included. The IHD population with NTIS was associated with higher risk of all-cause mortality (hazard ratio [HR] = 2.61; 95% confidence interval [CI] = 1.89-3.59) and MACE (HR = 2.22; 95% CI = 1.71-2.89) than that without. In addition, the IHD population with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10-1.97) and MACE (HR = 1.53; 95% CI = 1.19-1.97) than that without. In the subgroup analysis, the acute coronary syndrome (ACS) subpopulation with NTIS was associated with higher risk of all-cause mortality (HR = 3.30; 95% CI = 2.43-4.48) and MACE (HR = 2.19; 95% CI = 1.45-3.30). The ACS subpopulation with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.67; 95% CI = 1.17-2.39). Conclusions The IHD population with concomitant NTIS or hypothyroidism was associated with higher risk of all-cause mortality and MACE. Future research is required to provide evidence of the causal relationship and to elucidate whether normalizing thyroid function parameters can improve prognosis.


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