https://doi.org/10.55788/49d30727
eBRAVE-AF (NCT04250220) compared digital, smartphone-based screening to detect treatment-relevant AF in comparison to normal care [1]. Eligible 67,488 policyholders of a big German health insurer were invited by mail; 5,551 invitees gave consent over the downloaded study app. There was no in-person contact with participants at any time. The primary endpoint was newly diagnosed AF with consequent start of oral anticoagulation.
In the first 6 months, 2,860 randomised participants performed PPG self-measurements over 1 minute twice daily in week 1 and 2, followed by twice weekly. The other participants received usual care. The data were used for analysing primary efficacy. From months 7–12, a cross-over took place. In case of abnormal PPG findings, the patients received an external ECG loop recorder for 2 weeks. Treatment decisions based on these recordings were solely done by a local physician independent from the study.
“The participants in our study were 66 years old, one third were women, and the median CHA2DS2-VASc score was 3,” Prof. Axel Bauer (Innsbruck Medical University, Austria) described the cohort. Primary analysis showed a >2-fold significant superiority of the digital screening in terms of AF detection (OR 2.12; P=0.010). In the second stage, this difference was even higher with an OR of 2.75 (P=0.003). “A new diagnosis of AF, as well as new prescription with oral anticoagulation was more frequent with digital screening than usual care, while there were no differences with respect to clinical outcomes,” Prof. Bauer elaborated. All in all, 85 new cases of AF were found by digital screening, 69% resulting from PPG-measurements with consecutive ECG confirmation. Usual care detected 40 new cases of AF. A time-dependent Cox regression found a significant prediction of major adverse cardiac and cerebrovascular events for AF (HR 6.13), abnormal PPG (HR 2.74), and PPG plus ECG-confirmed AF (HR 3.22).
“Only future studies can inform us, whether improved AF diagnostics through digital technology really translates into better treatment outcomes,” Prof. Bauer concluded.
- Bauer A. eBRAVE-AF - Smartphone-based AF screening. Hot Line Session 6, ESC Congress 2022, Barcelona, Spain, 26–29 August.
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Table of Contents: ESC 2022
Featured articles
ESC Clinical Practice Guidelines
Prevention of VT and sudden cardiac death: the new recommendations
New and first ESC cardio-oncology guideline
The 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension
Cardiovascular assessment and management of patients undergoing non-cardiac surgery
Heart Failure
Old dogs, new tricks: Acetazolamide plus loop diuretics improves decongestion
No effect of neprilysin inhibition on cognition
Dapagliflozin DELIVERs for HFmrEF/HFpEF
Meta-analysis of DELIVER and EMPEROR-Preserved
Anticoagulation
Rheumatic heart disease-associated AF: standard-of-care holds ground
New anticoagulant safe and maybe effective: PACIFIC-AMI and PACIFIC-Stroke outcomes
AXIOMATIC-SSP: Reducing risk of ischaemic stroke with factor XIa inhibition?
Evolving evidence for P2Y12 inhibition in chronic coronary syndromes: PANTHER
Prevention
Danish study suggests starting CVD screening before age 70
Polypill SECUREs win in secondary prevention in elderly
Long-term therapy with evolocumab associated with lower CV mortality
ARBs + beta-blockers may delay Marfan syndrome aortic root replacement
ENTRIGUE: Subcutaneous pegozafermin in severe hypertriglyceridaemia
Artificial Intelligence & Digital Health – What Is New
First RCT evidence for use of AI in daily practice
AI-enhanced echography supports aortic stenosis patients
Ischaemia
Medical therapy versus PCI for ischaemic cardiomyopathy
Allopurinol disappoints in ALL-HEART
Conservative or invasive management for high-risk kidney disease patients with ischaemia?
Genotype-guided antiplatelet therapy in patients receiving PCI
Other HOTLINE Sessions
BOXing out oxygen and blood pressure targets
Coronary CT angiography diagnostics compared head-to-head
High-dose influenza vaccine: mortality benefit?
FFR-guided decision-making in patients with AMI and multivessel disease
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