Impact of optimized medical therapy and telemonitoring on functional status and rehospitalization in patients with chronic heart failure: a prospective cohort study
M Isailovic-Kekovic, P KekovicAbstract
Background
The combination of telemonitoring and guideline-directed medical therapy (GDMT) may improve outcomes in patients with heart failure (HF). Real-world data remain limited. This study evaluated the impact of this integrated approach on functional class, NT-proBNP, and rehospitalization over 6 months.
Methods
A total of 80 consecutive patients with chronic HF and reduced ejection fraction (LVEF ≤ 40%) were prospectively followed. All received optimized GDMT (ARNI/ACEI, beta-blocker, MRA and/or SGLT2 inhibitor) and participated in a low-resource telemonitoring program (weekly phone follow-ups and home monitoring of body weight and blood pressure). The primary endpoint was HF-related rehospitalization at 6 months. Secondary endpoints included changes in NT-proBNP and NYHA class.
Results
The proportion of patients in NYHA class III decreased from 62% to 38% during follow-up. NT-proBNP levels decreased from 3,420 pg/mL to 2,180 pg/mL (median –35%, p = 0.002). HF-related rehospitalization occurred in 17.5% of patients. Baseline NT-proBNP > 3000 pg/mL and ≥2 comorbidities were the strongest predictors of rehospitalization.
Conclusion
Optimized GDMT combined with simple telemonitoring was associated with improved functional class, reduced NT-proBNP, and lower rehospitalization rates. This approach is feasible and potentially effective for routine clinical practice.