Mixed Results for Wearables in Heart Disease

TOPLINE:

Wearable devices are associated with a reduced risk for major adverse cardiovascular events and all-cause mortality in patients with ischemic heart disease. However, evidence of their effects on outcomes including myocardial infarction, stroke, and cardiovascular mortality remains inconclusive.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis to study the impact of wearable devices, such as smartwatches, bands, patches, clothing, and shoes, combined with diverse technologies on cardiovascular outcomes in adult patients with ischemic heart disease.
• Six randomized clinical trials that included patients with ischemic heart disease (mean/median age, 43.2-75.6 years; 73%-82% men) were included in the final analysis, with meta-analyses performed when possible.
• Patients used wearable devices alongside either usual care alone or usual care plus additional interventions, and their outcomes were compared with those of patients who received only usual care.
• The outcomes of interest were myocardial infarction (MI), stroke, cardiovascular mortality, and their composite outcome of major adverse events. Other outcomes included all-cause mortality, heart failure, arrhythmias, hospitalizations, unstable angina, and revascularization procedures.

TAKEAWAY:

• Wearable devices did not significantly reduce the risks for MI or cardiovascular mortality. Meta-analysis could not be performed for stroke outcomes.
• However, wearable devices were associated with a 25% reduction in the risk for major adverse events (risk ratio [RR], 0.75; P = .03; two studies) and a 36% reduction in all-cause mortality (RR, 0.64; P = .03; three studies).
• The use of wearable devices had no significant effects on the risks for heart failure, all arrhythmias, or hospitalizations. Meta-analyses could not be conducted for unstable angina and revascularization procedures.
• ECG monitoring devices were associated with an increased detection of atrial fibrillation events (RR, 10.91; P

IN PRACTICE:

Wearable devices show growing potential in cardiovascular care as technology advances, especially for ischemic heart disease prevention, diagnosis, and management, wrote the authors.

“Nevertheless, many uncertainties remain surrounding the other outcomes, such as MI, stroke, cardiovascular mortality, hospitalizations, heart failure, unstable angina, and revascularization procedures,” they added.

SOURCE:

The study was led by Julia M.A. Ballavenuto, University of Birmingham, Birmingham, England. It was published online on December 24, 2024, in Maturitas.

LIMITATIONS:

The included studies showed significant clinical heterogeneity in patient presentations, types of interventions, and stages of disease. Additionally, variability in time of follow-up and inclusion of patients with unclear ischemic heart disease etiology in two studies might have affected the interpretation. Specific corrections for multiplicity could not be applied owing to the exploratory nature and the small number of studies in the meta-analysis.

DISCLOSURES:

No funding was received from any public, commercial, or not-for-profit organizations for this research. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.