Digital technology-enabled healthcare services and cardiovascular outcomes in patients with cardiovascular disease: a systematic review and meta-analysis.
5 affiliations
- 1Department of Cardiology, Toranomon Hospital, 2-2-2, Toranomon, Minato, Tokyo 105-8470, Japan.
- 2Division of Public Health and Division of Cardiovascular Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
- 3Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada.
- 4Department of Cardiology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo, Tokyo 104-8560, Japan.
- 5Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo 173-8606, Japan.
Abstract
Digital technology-enabled healthcare services may support secondary prevention in patients with cardiovascular disease; however, their effects on clinical outcomes remain uncertain. We performed a systematic review and meta-analysis to evaluate their impact on cardiovascular outcomes. PubMed and Embase were searched from inception to 11 March 2025. Randomized controlled trials evaluating digital technology-enabled healthcare services in patients with established cardiovascular disease were included. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), as defined in each trial. Secondary outcomes included rehospitalization, coronary artery disease-related events, all-cause mortality, cardiovascular mortality, revascularization, and adverse events. The protocol was registered in PROSPERO (CRD420251186138) Among 3603 records identified, 14 randomized controlled trials were included. Digital technology-enabled healthcare services were associated with a reduced risk of MACCE (risk ratio 0.595; 95% confidence interval 0.471-0.752; I ² = 0%). Rehospitalization (risk ratio 0.676; 95% confidence interval 0.496-0.923; I ² = 73.9%) and coronary artery disease-related events (risk ratio 0.594; 95% confidence interval 0.354-0.996; I ² = 0%) were also reduced. There were no significant differences in all-cause mortality, cardiovascular mortality, or revascularization (all I ² = 0%). No significant difference in adverse events was observed between groups (I ² = 45.9%). Digital technology-enabled healthcare services were associated with a lower risk of cardiovascular events in patients with established cardiovascular disease. However, substantial heterogeneity was observed for rehospitalization, and no significant reductions were observed in mortality outcomes. Registration PROSPERO identifier: CRD420251186138.
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BibTeX
@article{kuwabara2026digital,
title = {{Digital technology-enabled healthcare services and cardiovascular outcomes in patients with cardiovascular disease: a systematic review and meta-analysis.}},
author = {Masanari Kuwabara and Tetsuo Yamaguchi and Ayako Harima and Chinatsu Komiyama and Takayoshi Kanie and Atsushi Mizuno and Ken Kozuma and Takahide Kodama},
journal = {European heart journal open},
year = {2026},
month = sep,
doi = {10.1093/ehjopen/oeag156},
url = {https://europepmc.org/article/MED/42910079},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Digital technology-enabled healthcare services and cardiovascular outcomes in patients with cardiovascular disease: a systematic review and meta-analysis.
AU - Masanari Kuwabara
AU - Tetsuo Yamaguchi
AU - Ayako Harima
AU - Chinatsu Komiyama
AU - Takayoshi Kanie
AU - Atsushi Mizuno
AU - Ken Kozuma
AU - Takahide Kodama
PY - 2026
DA - 2026/09/25
JO - European heart journal open
DO - 10.1093/ehjopen/oeag156
UR - https://europepmc.org/article/MED/42910079
AB - Digital technology-enabled healthcare services may support secondary prevention in patients with cardiovascular disease; however, their effects on clinical outcomes remain uncertain. We performed a systematic review and meta-analysis to evaluate their impact on cardiovascular outcomes. PubMed and Embase were searched from inception to 11 March 2025. Randomized controlled trials evaluating digital technology-enabled healthcare services in patients with established cardiovascular disease were included. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), as defined in each trial. Secondary outcomes included rehospitalization, coronary artery disease-related events, all-cause mortality, cardiovascular mortality, revascularization, and adverse events. The protocol was registered in PROSPERO (CRD420251186138) Among 3603 records identified, 14 randomized controlled trials were included. Digital technology-enabled healthcare services were associated with a reduced risk of MACCE (risk ratio 0.595; 95% confidence interval 0.471-0.752; I ² = 0%). Rehospitalization (risk ratio 0.676; 95% confidence interval 0.496-0.923; I ² = 73.9%) and coronary artery disease-related events (risk ratio 0.594; 95% confidence interval 0.354-0.996; I ² = 0%) were also reduced. There were no significant differences in all-cause mortality, cardiovascular mortality, or revascularization (all I ² = 0%). No significant difference in adverse events was observed between groups (I ² = 45.9%). Digital technology-enabled healthcare services were associated with a lower risk of cardiovascular events in patients with established cardiovascular disease. However, substantial heterogeneity was observed for rehospitalization, and no significant reductions were observed in mortality outcomes. Registration PROSPERO identifier: CRD420251186138.
SN - 2752-4191
ER -