Cureus. 2026 Aug 20;18(8):e114865. doi: 10.7759/cureus.114865. eCollection 2026 Aug.
ABSTRACT
Background Coronary artery disease (CAD) remains a major cause of morbidity and mortality worldwide. Despite advances in percutaneous coronary intervention (PCI), recurrent cardiovascular events remain common due to gaps in secondary prevention and long-term follow-up. Telemedicine offers a potential solution by improving access to care, patient engagement, and risk-factor monitoring. Methods This single-center, open-label randomized controlled trial included 106 patients undergoing PCI at All India Institute of Medical Sciences (AIIMS), Rishikesh, India, who were randomized 1:1 to structured tele-follow-up (WhatsApp, SMS, and audio/video consultations) or standard outpatient follow-up. Of these, 100 participants completed follow-up and were included in the available-case analysis. The primary outcome was major adverse cardiovascular events (MACEs) assessed at prespecified one-, three-, and six-month follow-up assessments. Secondary outcomes included medication adherence, lipid control, blood pressure control, glycemic control, lifestyle modification, and hospital readmissions. Results The mean age was 55.5 ± 9.2 years, and 88% were male. MACE rates were comparable between groups throughout follow-up (p > 0.05). Tele-follow-up achieved significantly lower low-density lipoprotein cholesterol (LDL-C) levels at one month (69.72 vs. 87.08 mg/dL, p = 0.003) and at six months (53.90 vs. 63.58 mg/dL, p = 0.014). Blood pressure control was generally comparable between groups, with an isolated lower diastolic blood pressure in the tele-follow-up group at one month that was not sustained at subsequent follow-up. Medication adherence was ≥94% in both groups throughout follow-up. No significant differences were observed in HbA1c, systolic blood pressure, bleeding events, stent failure, or mortality. Conclusions Structured tele-follow-up after PCI was feasible, with observed short-term clinical outcomes comparable to standard follow-up. It was associated with better lipid control, while blood pressure control was broadly similar between the groups. Tele-follow-up may therefore be a practical and scalable follow-up strategy after PCI, particularly in resource-limited settings. Larger multicenter studies with longer follow-up are needed to confirm its impact on clinical outcomes.
PMID:42763699 | PMC:PMC13589602 | DOI:10.7759/cureus.114865