Abstract 12125: Ambulatory Pulmonary Artery Pressure-Guided Therapy in Patients With Chronic Heart Failure: A Systematic Review and Meta-Analysis

Abstract

Background: In the past year, an implantable pulmonary artery pressure (PAP) sensor with CardioMEMS was approved by the FDA for heart failure (HF) patients with New York Heart Association (NYHA) class III or those with HF-related hospitalization (HFH). However, recent guidelines have not strongly recommended adding the PAP sensor to the standard of care in chronic HF patients. Objectives: We conducted this systematic review and meta-analysis to evaluate whether remote PAP-guided therapy can improve outcomes in chronic HF patients. Methods: We searched MEDLINE and Embase databases from inception to May 2022 to identify studies that compared outcomes of interest, including HFH and all-cause mortality in patients with HF who received remote PAP sensors in addition to the standard of care and those with the standard of care alone. Data from each study were combined using the random-effects model. Results: Four studies (2 randomized controlled trials and 2 matched cohort studies) with 7,505 patients (3,693 in the PAP sensor group and 3,812 in the control group) were included. The use of implantable PAP sensors in patients with chronic HF was associated with significantly lower HFH (hazard ratio (HR) = 0.76, 95% conference interval (CI) 0.68-0.84, p<0.001) and all-cause mortality (HR=0.73, 95%CI 0.62-0.85, p<0.001) as shown in Figure 1. Conclusions: Our meta-analysis demonstrated a significant reduction in HFH and mortality in HF patients with NYHA class III and remote PAP-guided therapy. Adding an ambulatory PAP sensor to the standard care may improve outcomes in chronic HF patients with NYHA class III.