Abstract
The effectiveness of digital health management (DM) in post-discharge care for patients with coronary artery disease (CAD) remains insufficiently explored, particularly across public health emergencies. A total of 24,129 patients with CAD enrolled in the HeartMed Digital Management System were divided into DM or conventional management groups based on patient preference, and categorized into pre-COVID-19 (n = 13,473; 16.7% DM), COVID-19 (n = 5173; 80.3% DM), and post-COVID-19 (n = 5483; 86.2% DM) eras according to enrollment dates. For the primary endpoint, digital healthcare was significantly associated with lower all-cause mortality risk across all three periods after adjustment (HR: pre-COVID 0.23; COVID 0.52; post-COVID 0.58; all p < 0.001). No significant interaction was found in the protective effect of DM among the three eras (all interaction p > 0.05). Similar trends were observed for the secondary endpoints-readmission, MACE, and MACCE. Across all three pandemic phases, DM was consistently associated with improved clinical outcomes in post-discharge CAD populations.