{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:04:46Z","timestamp":1784613886803,"version":"3.55.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate a multimodal digital health intervention (SK-121) as an adjunct to standard of care (SoC) to reduce the risk of recurrent cardiovascular events in patients following percutaneous coronary intervention (PCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      In this single-centre, randomised controlled trial of 200 patients (mean age 64.4 years; 79.5% male) who underwent PCI, patients were randomised 1:1 to receive SoC alone or SoC plus a 48-week gamified digital program focusing on lifestyle modification and remote patient monitoring (RPM). User retention and engagement were high with 84% remaining active at 24 weeks and weekly RPM completion averaging 94%. The primary endpoint was the baseline-adjusted between-group difference in the Second Manifestations of ARTerial disease, version 2 (SMART2) risk score at 6 months. These SMART2 scores did not differ between the intervention and control groups (adjusted mean difference \u22120.3%; 95% confidence interval \u22122.4% to 1.9%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.821). However, the intervention group significantly improved in disease knowledge at 6 and 12 months (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and medication adherence at 6 months (\n                      <jats:italic>P<\/jats:italic>\n                      =0.030). Diastolic blood pressure was significantly lower in the intervention group at 12 months (\u22123.7 mmHg;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). In a\n                      <jats:italic>post hoc<\/jats:italic>\n                      exploratory hypothesis-generating subgroup analysis of overweight participants, the intervention significantly reduced SMART2 scores at 12 months compared to controls (\u22123.7%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While the intervention did not reduce the SMART2 risk score in the overall population, it significantly improved disease knowledge, short-term medication adherence, and diastolic blood pressure. The program was well-accepted and may offer prognostic benefits for overweight patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/clinicaltrials.gov\/study\/NCT05713565<\/jats:ext-link>\n                      , NCT05713565.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1851777","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:34:02Z","timestamp":1784612042000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of a digital health solution after percutaneous coronary intervention: a randomised controlled trial"],"prefix":"10.3389","volume":"8","author":[{"given":"Elias Freyr","family":"Gudmundsson","sequence":"first","affiliation":[{"name":"Sidekick 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