Department of Cardiology, South Karelia Central Hospital, Lappeenranta, Finland.
Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.
ESC Heart Fail. 2021 Oct;8(5):3696-3708. doi: 10.1002/ehf2.13475. Epub 2021 Jun 24.
We planned this systematic review and meta-analysis to study an estimate of the effect of non-invasive home telemonitoring (TM) in the treatment of patients with recently decompensated heart failure (HF). A systematic literature search was conducted in the Medline, Cinahl, and Scopus databases to look for randomized controlled studies comparing TM with standard care in the treatment of patients with recently decompensated HF. The main outcomes of interest were all-cause hospitalizations and mortality. Eleven original articles met our eligibility criteria. The pooled estimate of the relative risk of all-cause hospitalization in the TM group compared with standard care was 0.95 (95% CI 0.84-1.08, P = 0.43) and the relative risk of all-cause death was 0.83 (95% CI 0.63-1.09, P = 0.17). There was significant clinical heterogeneity among primary studies. HF medication could be directly altered in three study interventions, and two of these had a statistically significant effect on all-cause hospitalizations. The pooled effect estimate of TM interventions on all-cause hospitalizations and all-cause death in patients with recently decompensated heart failure was neutral.
我们计划进行这项系统评价和荟萃分析,以研究非侵入性家庭远程监测(TM)在治疗近期失代偿性心力衰竭(HF)患者中的效果估计。在 Medline、Cinahl 和 Scopus 数据库中进行了系统文献检索,以寻找比较 TM 与标准护理治疗近期失代偿性 HF 患者的随机对照研究。主要观察指标为全因住院和死亡率。符合纳入标准的有 11 篇原始文章。与标准护理相比,TM 组全因住院的相对风险估计值为 0.95(95%CI 0.84-1.08,P=0.43),全因死亡的相对风险估计值为 0.83(95%CI 0.63-1.09,P=0.17)。主要研究之间存在显著的临床异质性。HF 药物在三个研究干预中可以直接改变,其中两个对全因住院有统计学意义。TM 干预对近期失代偿性心力衰竭患者的全因住院和全因死亡的汇总效应估计值为中性。