TELESAT-HF study: persistent reduction of all-cause mortality across age categories in a real-world heart failure population

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Abstract Objective To evaluate the nationwide impact of a remote monitoring program on all-cause mortality in heart failure patients compared with those receiving standard of care alone, with a focus on age categories. Background and Aims Heart failure (HF) affects approximately 64 million people worldwide, and its prevalence continues to rise. With the advent of remote information and communication technologies, remote monitoring may represent a significant advancement in HF management. This study investigates the national impact of integrating a remote monitoring program (RMP) with standard HF care on all-cause mortality across various patient subgroups, underlining that age is not a barrier to benefiting from remote monitoring. Methods In this multicenter, real-world, propensity-weighted study, data were drawn from the French National Health Database (SNDS) spanning August 2018 to December 2022, covering more than 300 healthcare centers. Patients in the RMP group received standard care (SoC) enhanced by RMP using Satelia Cardio system (which includes symptom and weight tracking along with algorithm-driven therapeutic education), whereas the control group received SoC only. The primary endpoint was all-cause mortality with survival assessed using Kaplan-Meier analysis and comparisons made via an adjusted Cox regression model. Subgroup analyses were conducted by age, sex, digital literacy, with a particular focus on demonstrating that remote monitoring is effective regardless of age. Results After propensity weighting, 5,357 in the RMP group and 13,525 in the SoC group demonstrated comparable baseline characteristics. Overall (ref 1), the Satelia Cardio RMP was associated with a significant reduction in all-cause mortality (HR=0.639, 95% CI [0.59–0.70], p<0.0001; NNT=10.5). The benefit was consistent across age categories, with patients under 80 years showing an HR of 0.625, and those aged 80 years or older an HR of 0.596, demonstrating that even older patients experience a notable reduction in mortality. In the sub-group analysis by sex, Satelia Cardio use is linked to a 38% mortality reduction in men (HR = 0.62) and a 42% reduction in women (HR = 0.58). Additionally, patient-centered remote monitoring was particularly effective (HR=0.535) compared with interventions relying solely on nurse calls (HR=0.668) in users with low digital literacy. Conclusions The findings reveal a significant 36% reduction in all-cause mortality with the Satelia Cardio RMP compared to standard care, with robust benefits observed even in elderly patients. These results highlight that age should not be a deterrent in offering remote monitoring, and they underscore the value of a patient-centered approach in improving outcomes across the heart failure population. Association of RMP & all-cause mortality

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