App-based lifestyle modification after percutaneous coronary intervention: A multicenter randomized controlled trial

Area of Science:

• Cardiovascular Medicine
• Digital Health
• Rehabilitation Science

Background:

• Long-term outcomes after percutaneous coronary intervention (PCI) are often suboptimal, with non-target lesion stenosis progression being a key issue.
• Lifestyle modifications are crucial for improving outcomes, but adherence can be challenging.
• Digital health interventions offer a novel approach to support lifestyle changes in post-PCI patients.

Purpose of the Study:

• To assess the effectiveness of a 14-week app-based lifestyle modification program using IoT devices compared to usual care in post-PCI patients.
• To evaluate the impact of the intervention on peak oxygen uptake (VO2), coronary risk factors (CRFs), physical activity, and quality of life.

Main Methods:

• A multicenter, open-label, randomized controlled trial involving 152 post-PCI patients.
• Patients were assigned to either an app-based lifestyle intervention group or a usual care control group.
• Primary endpoint was achieving ≥10% improvement in peak VO2; secondary endpoints included CRF targets, physical activity, quality of life, and adherence.

Main Results:

• No significant difference was observed in the proportion of patients achieving ≥10% improvement in peak VO2 between the intervention and control groups (41% vs. 39%, p=0.786).
• The intervention group showed significantly better lipid control compared to the control group (56.0% vs. 39.5%, p=0.042).
• Other risk factors and adherence did not show significant differences, though a complete-case analysis suggested potential benefits in CRF management for the intervention group.

Conclusions:

• The app-based lifestyle intervention did not significantly improve peak oxygen uptake compared to usual care in post-PCI patients.
• A trend towards improved lipid control was observed, indicating potential benefits of digital health interventions in managing coronary risk factors.
• Further research with enhanced app quality and more robust outcome measures is warranted to fully determine the clinical utility of such digital health programs in cardiac rehabilitation.