Trial Summary
What is the purpose of this trial?This study seeks to expand the use of the NYU GeriKit mobile application ("app") in a diverse range of settings to better phenotype older patients, which will enhance both research and patient care.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the GeriKit App treatment for ischemic heart disease?
Research shows that mobile apps can help people with heart conditions stick to their medication and make healthier lifestyle choices. In one study, patients using a mobile app after heart procedures had better medication compliance and fewer adverse events compared to those who didn't use the app.
12345How does the GeriKit App treatment for ischemic heart disease differ from other treatments?
The GeriKit App is unique because it likely involves a digital or software-based approach to managing ischemic heart disease, which is different from traditional drug or surgical treatments. This app may offer novel ways to monitor and manage heart health through technology, potentially providing real-time data and personalized insights for patients.
678910Eligibility Criteria
This trial is for individuals aged 75 or older who are currently hospitalized or were hospitalized within the past month for heart-related procedures like AMI, PCI, or CABG. Participants must be able to consent and perform study tasks in English. Those with severe cognitive issues, non-ambulatory status, incarceration, or inability to complete assessments in English cannot join.Inclusion Criteria
I am able to understand and agree to the study on my own.
I am in the hospital or was recently hospitalized for a heart attack or heart surgery.
Understand and are able to perform study procedures in English
+1 more
Exclusion Criteria
Unable or unwilling to consent
Currently in prison.
I have been diagnosed with dementia.
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Baseline Assessment
Participants receive comprehensive geriatric assessment via GeriKit app
1 day
1 visit (in-person)
Follow-up
Participants complete a follow-up assessment via phone
6 months
1 visit (virtual)
Qualitative Questionnaire
20 participants complete a qualitative questionnaire after the 6-month follow-up
1 day
1 visit (virtual)
Participant Groups
The trial is testing the GeriKit mobile application's effectiveness in assessing older adults with ischemic heart disease. The goal is to improve patient care and research by better understanding this population through the app's use.
1Treatment groups
Experimental Treatment
Group I: Geriatric Assessments using GeriKit AppExperimental Treatment1 Intervention
Participants will receive comprehensive geriatric assessment via GeriKit app at baseline. All participants will complete a follow-up assessment via phone at 6 months. 20 of the 150 enrolled participants will continue onto a qualitative questionnaire after the completion of the 6-month follow up call.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
NYU Langone HealthNew York, NY
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Who Is Running the Clinical Trial?
NYU Langone HealthLead Sponsor
National Institutes of Health (NIH)Collaborator
References
Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study. [2018]Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients.
The effect of mobile application-based technology use on medication compliance and modification of risk factors in post PTCA cohort of patients. [2022]Mobile application-based technology was used to study medication compliance and influence on cardiovascular lifestyle in ischemic heart disease (IHD) patients who undergo percutaneous transluminal coronary angioplasty (PTCA). The Mobile-app was made available at Google play store; the app was downloaded and instructions to use were thought to patients by the research team during hospitalization in the study group. A total of two hundred patients with ischemic heart disease who underwent PTCA were enrolled into the study. The control group had telephonic follow up at periodic interval. Both groups had clinical follow ups at appropriate time intervals. Higher medication compliance, smaller number of adverse events and regular follow ups were significantly more in mobile-app group than in control group.
Feasibility of using a mobile application for the monitoring and management of stroke-associated risk factors. [2022]Recent advances in information technology have created opportunities for advances in the management of stroke. The objective of this study was to test the feasibility of using a smartphone software application (app) for the management of vascular risk factors in patients with stroke.
Mobile app and digital system for patients after myocardial infarction (afterAMI): study protocol for a randomized controlled trial. [2022]Treatment of acute myocardial infarction has been the subject of studies over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient's prognosis. It is extremely important to take care of all cardiovascular risk factors and undergo a full rehabilitation program. Telemedical solutions are becoming more and more relevant in everyday practice. We describe a protocol of a study evaluating the use of the mobile application "afterAMI" in patients after myocardial infarction. The app offers an educational mode, calendar, vital signs diary, medication reminders, medical history card, and healthcare professional contact panel. It offers several solutions, which individually proved to be effective and improve a patient's prognosis. Despite general promising results from previous studies regarding telemedical tools, there is a paucity of evidence when it comes to prospective randomized trials. Our aim was to perform a comprehensive evaluation of a newly developed mobile application in the clinical setting.
Internet-based training of coronary artery patients: the Heart Cycle Trial. [2022]Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System). This consisted of a sensor monitoring breathing rate and the electrocardiogram that transmitted information on training intensity, arrhythmias and adherence to training prescriptions, wirelessly via the internet, to a medical team that provided feedback and adjusted training prescriptions. Exercise capacity was evaluated prior to and 6 months after intervention. 118 patients (58 ± 10 years, 105 men) with CAD referred for CR were randomized (IG: n = 55, CG: n = 63). However, 15 patients (27 %) in the IG and 18 (29 %) in the CG withdrew participation and technical problems prevented a further 21 patients (38 %) in the IG from participating. No training-related complications occurred. For those who completed the study, peak VO2 improved more (p = 0.005) in the IG (1.76 ± 4.1 ml/min/kg) compared to CG (-0.4 ± 2.7 ml/min/kg). A newly designed system for home-based CR appears feasible, safe and improves exercise capacity compared to national CR. Technical problems reflected the complexity of applying remote monitoring solutions at an international level.
Evaluation of data in cardiology by new software tools. [2015]We describe an analysis of cardiology data using new software tools. First we use data of 1417 men aged 40 to 50 years living in the center of Prague gathered in the twenty years lasting longitudinal study. We show some results of application of the programs E.T. (Epidemiology Tools) and CORE (COnstitution and REduction of data). Second we show the way of application of the program HYPERTENSION, that supports decision making in therapy of arterial hypertension.
Total ischemic burden in patients with coronary artery disease. [2019]In patients with coronary artery disease, angina pectoris provides an unreliable underestimation of disease activity and risk. Unheralded myocardial infarction and sudden death are common clinical presentations. Furthermore, objective testing, in hospital and more recently during the patient's normal daily activities, has demonstrated frequent and asymptomatic episodes of ischemia, as indicated by transient ST-segment depression. Since the underlying pathophysiologic disturbances of myocardial perfusion appear to be similar in painful and painless episodes, it seems appropriate to consider them together as the "total ischemic burden" on the myocardium. Research into this functional expression of coronary disease has indicated that active ischemia is associated with an increased risk of morbid events in all clinical subgroups of patients, including those with stable angina, unstable angina, peripheral vascular disease and following myocardial infarction. If this is confirmed in prospective trials, the assessment of total ischemic burden is likely to become part of the clinical investigation of patients with coronary disease. Clinical trials testing the efficacy of interventions will need to examine the effect on ischemic activity during normal daily life, in addition to symptoms and exercise tolerance. Evidence is still required to demonstrate whether therapy aimed at reducing the total ischemic burden will prolong life. The total ischemic burden provides a marker to follow the dynamic changes of the atherosclerotic lesion. Future research may have to concentrate on treatment aimed at altering the natural history of obstructive coronary atherosclerosis in order to affect the long-term outlook for patients with coronary artery disease.
Visual Evidence of Ischemic Preconditioning During PCI Using 80 Lead ECG Body Surface Mapping. [2021]Ischemic preconditioning (IPC) is a well-documented phenomenon. Short episodes of sublethal ischemia provide cardioprotective effects for subsequent longer duration ischemic events. Although the exact mechanism of IPC is not yet known, the chemical basis of IPC seems to involve preservation of ATP or collateral vascularization recruitment. In this case report, we present visual evidence of ischemic preconditioning using Heartscape Technologies 80 Lead ECG device. The 80 Lead ECG is described as a body surface mapping modality, converting its inputted 80 lead ECG data into a 3-Dimensional color coded map. The 80 lead ECG device can detect instantaneous ischemic changes. Different studies have been performed to show different clinical and biochemical aspects of IPC. However data regarding direct visual evidence of this phenomenon is lacking. The secondary objective of this study is to show the ability of 80 lead ECG to identify ST-segment elevation and depression during ischemic events. The utility of 80 Lead ECG body surface mapping is enormous when evaluating ischemic events.
Application of computerized exercise ECG digitization. Interpretation in large clinical trials. [2022]The authors report on a semiautomated program that incorporates both visual identification of fiducial points and digital determination of the ST-segment at 60 ms and 80 ms from the J point, ST slope, changes in R wave, and baseline drift. The off-line program can enhance the accuracy of detecting electrocardiographic (ECG) changes, as well as reproducibility of the exercise and postexercise ECG, as a marker of myocardial ischemia. The analysis program is written in Microsoft QuickBASIC 2.0 for an IBM personal computer interfaced to a Summagraphics mm1201 microgrid II digitizer. The program consists of the following components: (1) alphanumeric data entry, (2) ECG wave form digitization, (2) calculation of test results, (4) physician overread, and (5) editor function for remeasurements. This computerized exercise ECG digitization-interpretation program is accurate and reproducible for the quantitative assessment of ST changes and requires minimal time allotment for physician overread. The program is suitable for analysis and interpretation of large volumes of exercise tests in multicenter clinical trials and is currently utilized in the TIMI II, TIMI III, and BARI studies sponsored by the National Institutes of Health.
Activity of transient myocardial ischemia out of hospital in coronary artery disease and implications for management. [2019]The management of patients with angina pectoris is based largely on the severity of symptoms, coronary anatomy and left ventricular function. The outcome for these patients is highly variable and depends largely on the degree of ischemic damage to the left ventricular myocardium. Recent work suggests that exercise-induced myocardial ischemia with or without angina is associated with a poor prognosis. Ambulatory monitoring of the electrocardiogram has revealed that most patients have frequent and prolonged episodes of transient ischemia out of hospital. These episodes are often asymptomatic and associated with ordinary everyday activities. In addition, ambulatory monitoring has demonstrated that transient ischemia during daily life has a circadian variation with exacerbations and peak density of ischemia in the first 4 to 6 waking hours of the day. Further studies have demonstrated that regional decreases in coronary blood flow occur during these ischemic episodes and have the same features seen out of hospital on continuous monitoring. These newly noted characteristics of transient ischemia raise a number of practical questions for treatment. Is it necessary to relieve all ischemic activity quite apart from that which occurs with chest pain? Does present use of antianginal medication neglect the early morning increases in transient ischemia that occur, and are different dosage regimens required to treat ischemia adequately? Does suppression of all ischemic activity further protect myocardium and improve prognosis for the patient?