Zito, Andrea, Princi, Giuseppe, Romiti, Giulio Francesco, Galli, Mattia, Basili, Stefania, Liuzzo, Giovanna, Sanna, Tommaso, Restivo, Attilio, Ciliberti, Giuseppe, Trani, Carlo et al (show 5 more authors)
(2022)
Device-based remote monitoring strategies for congestion-guided management of patients with heart failure: a systematic review and meta-analysis.
EUROPEAN JOURNAL OF HEART FAILURE, 24 (12).
pp. 2333-2341.
Abstract
<h4>Aims</h4>Pre-clinical congestion markers of worsening heart failure (HF) can be monitored by devices and may support the management of patients with HF. We aimed to assess whether congestion-guided HF management according to device-based remote monitoring strategies is more effective than standard therapy.<h4>Methods and results</h4>A comprehensive literature research for randomized controlled trials (RCTs) comparing device-based remote monitoring strategies for congestion-guided HF management versus standard therapy was performed on PubMed, Embase, and CENTRAL databases. Incidence rate ratios (IRRs) and associated 95% confidence intervals (CIs) were calculated using the Poisson regression model with random study effects. The primary outcome was a composite of all-cause death and HF hospitalizations. Secondary endpoints included the individual components of the primary outcome. A total of 4347 patients from eight RCTs were included. Findings varied according to the type of parameters monitored. Compared with standard therapy, haemodynamic-guided strategy (4 trials, 2224 patients, 12-month follow-up) reduced the risk of the primary composite outcome (IRR 0.79, 95% CI 0.70-0.89) and HF hospitalizations (IRR 0.76, 95% CI 0.67-0.86), without a significant impact on all-cause death (IRR 0.93, 95% CI 0.72-1.21). In contrast, impedance-guided strategy (4 trials, 2123 patients, 19-month follow-up) did not provide significant benefits.<h4>Conclusion</h4>Haemodynamic-guided HF management is associated with better clinical outcomes as compared to standard clinical care.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Heart failure, Guided management, Remote monitoring, Telemonitoring, Hospitalization, Death |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 18 May 2023 10:19 |
| Last Modified: | 18 May 2023 10:19 |
| DOI: | 10.1002/ejhf.2655 |
| Open Access URL: | https://doi.org/10.1002/ejhf.2655 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3170484 |
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