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远程医疗改善了直接经皮冠状动脉介入治疗后急性ST段抬高型心肌梗死的短期医疗护理。

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention.

作者信息

Kamel Heba, Hafez Mohamed Saber, Bastawy Islam

机构信息

Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Front Cardiovasc Med. 2021 Jul 12;8:693731. doi: 10.3389/fcvm.2021.693731. eCollection 2021.

Abstract

Telemedicine appears to be a promising tool for healthcare professionals to deliver remote care to patients with cardiovascular diseases especially during the COVID-19 pandemic. We aimed in this study to evaluate the value of telemedicine added to the short-term medical care of acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Two hundred acute STEMI patients after primary PCI were randomly divided into two groups. One hundred patients in group A (study group) received a monthly videoconferencing teleconsultation using a smartphone application for 3 months starting 1 week after discharge and at least a single face-to-face (F2F) clinic visit. We reviewed in each virtual visit the symptoms of patients, adherence to healthy lifestyle measures, medications, smoking cessation, and cardiac rehabilitation. Group B (control group) included 100 patients who received at least a single F2F clinic visit in the first 3 months after discharge. Both groups were interviewed after 4 months from discharge for major adverse cardiac events (MACE), adherence to medications, smoking cessation, and cardiac rehabilitation. A survey was done to measure the satisfaction of patients with telemedicine. There was no significant difference between both groups in MACE and their adherence to aspirin, P2Y12 inhibitor, and beta-blockers. However, group A patients had better adherence to statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, smoking cessation, and cardiac rehabilitation. Sixty-one percent of patients stated that these videoconferencing teleconsultations were as good as the clinic visits, while 87% of patients were satisfied with telemedicine. Telemedicine may provide additional benefit to the short-term regular care after primary PCI to STEMI patients through videoconferencing teleconsultations by increasing their adherence to medications and healthy lifestyle measures without a significant difference in the short-term MACE. These virtual visits gained a high level of satisfaction among the patients.

摘要

远程医疗似乎是医疗保健专业人员为心血管疾病患者提供远程护理的一种有前途的工具,尤其是在新冠疫情期间。我们在本研究中的目的是评估在急性ST段抬高型心肌梗死(STEMI)患者接受直接经皮冠状动脉介入治疗(PCI)后的短期医疗护理中增加远程医疗的价值。200例直接PCI术后的急性STEMI患者被随机分为两组。A组(研究组)100例患者在出院1周后开始使用智能手机应用程序进行每月一次的视频会议远程会诊,为期3个月,并至少进行一次面对面(F2F)门诊就诊。我们在每次虚拟就诊中查看患者的症状、对健康生活方式措施的依从性、用药情况、戒烟情况和心脏康复情况。B组(对照组)包括100例在出院后的前3个月至少进行一次F2F门诊就诊的患者。两组患者在出院4个月后接受关于主要不良心脏事件(MACE)、用药依从性、戒烟情况和心脏康复情况的访谈。进行了一项调查以衡量患者对远程医疗的满意度。两组在MACE以及对阿司匹林、P2Y12抑制剂和β受体阻滞剂的依从性方面没有显著差异。然而,A组患者对他汀类药物、血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂的依从性更好,戒烟情况和心脏康复情况也更好。61%的患者表示这些视频会议远程会诊与门诊就诊一样好,而87%的患者对远程医疗感到满意。通过视频会议远程会诊,远程医疗可能会为STEMI患者PCI术后的短期常规护理带来额外益处,通过提高他们对药物和健康生活方式措施的依从性,同时在短期MACE方面没有显著差异。这些虚拟就诊在患者中获得了很高的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1cb/8311002/408d2e5b8f6d/fcvm-08-693731-g0001.jpg

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