Digital health interventions for post-myocardial infarction rehabilitation: a randomized Trial on wearable technology adherence and cardiac outcomes

This randomized controlled trial sought to investigate the effect of digital health interventions on rehabilitation adherence and improved cardiac outcomes after myocardial infarction among Uzbekistani patients. 300 patients with myocardial infarction (average age 58.4 ± 9.2 years, 65% male) were randomized to the intervention group (n = 150) that used wearable activity monitoring devices and companion programs for rehabilitation or to the control group (n = 150) that received usual care. Follow-up was 6 months, and outcomes included adherence to the rehabilitation program, readmission, mortality, ventricular ejection fraction (EF) improvement, and exercise capacity (6-minute walk test). The outcome of interest was that significantly more adherence to the rehabilitation program was noted in the intervention group (82.3% versus 57.6% in the control group, p<0.001). Furthermore, cardiac readmission was 9.1% in the intervention group and 22.4% in the control group (p=0.003). Total mortality was 2.0% in the intervention group and 6.2% in the control group (p=0.04). Ventricular ejection fraction improvement was 12.5% ± 4.1% in the intervention group and 5.8% ± 3.9% in the control group (p<0.001). Exercise capacity also increased by 35.7% in the intervention group, as opposed to 15.2% among the control group (p=0.002). The findings confirm the therapeutic role of wearable technologies in the enhancement of rehabilitation adherence and augmentation of clinical outcomes after myocardial infarction. The study identifies the core position of digital health interventions within cardiovascular healthcare systems, especially where resources are constrained.