Impact of Infarct Type on Serious Arrhythmic Event Detection and Cardiovascular Outcomes During Telemedical Monitoring After Myocardial Infarction: A SMART-MI substudy
Primary result · SArE detection, STEMIResult — go to the resultHazard ratio 11.99 95% CI 3.67–39.17Authors' conclusion
ICM-based telemonitoring increased SArE detection in both STEMI and NSTEMI patients and detected SArE were associated with subsequent MACCE in both infarct types. These findings support further investigation of intensified rhythm-surveillance strategies in high-risk STEMI and NSTEMI patients.
Study context
- Population
- Myocardial infarction (MI) survivors with LVEF 36–50% and cardiac autonomic dysfunctionrandomized
- Participants
- 400 survivors
- Comparison
- Implantable cardiac monitor (ICM)-based telemonitoring or conventional follow-up
- ICM implantationn = 201
- Conventional follow-upn = 199
Methodological detailsrandomized, exploratory analyses
- Randomized
- Exploratory analyses
Primary result
SArE detection, STEMI
Hazard ratio
11.99
95% CI 3.67–39.17
P < 0.001
ICM implantationvs conventional follow-up
HR 11.99 (95% CI 3.67–39.17); P < 0.001
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| SArE detection, NSTEMINSTEMI | 4.44 (2.09–9.43) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
- Serious arrhythmic events (SArE) detection, NSTEMI: p for interaction=0.154
Subsequent major adverse cardiovascular and cerebrovascular events (MACCE) associated with detected SArE
- STEMI, HR
- 7.77 (95% CI 3.20-18.86)
- NSTEMI, HR
- 4.26 (95% CI 1.44-12.58)
- Exploratory; detected SArE as time-dependent covariate, stratified by arm
Original publication
Impact of Infarct Type on Serious Arrhythmic Event Detection and Cardiovascular Outcomes During Telemedical Monitoring After Myocardial Infarction: A SMART-MI substudy. Heart Rhythm. Published 4 November 2026. doi:10.
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