The goal of this clinical trial is to learn if an AI-enabled stratified management system (SMART-CHD) can improve post-discharge outcomes in adults aged 18-45 with premature coronary artery disease. The main questions it aims to answer are:
1. Does SMART-CHD reduce the combined rate of all-cause death, myocardial infarction, stroke and rehospitalization within 12 months? 2. Does SMART-CHD achieve better control of modifiable risk factors compared with usual care?
Researchers will compare SMART-CHD to standard discharge management (verbal and printed instructions on medications, follow-up timelines and lifestyle advice) to see if the AI-driven platform leads to fewer adverse events and improved risk-factor profiles.
Participants will:
1. Install and use the SMART-CHD mobile app after a 10-minute structured orientation session with supervised simulations. 2. Complete regular in-app surveys on lifestyle behaviors, laboratory/imaging results and clinical events (with OCR-powered LLM assistance). 3. Wear paired sensors for continuous monitoring of blood pressure, heart rate and other physiologic metrics. 4. Receive automated EHR data harvesting, AI-driven voice-call reminders, and real-time CRC support via a dedicated WeChat group. 5. Follow personalized, guideline-based risk-factor recommendations (diet, exercise, sleep, weight, smoking, alcohol, hypertension, dyslipidemia, diabetes).
Patients with coronary heart disease aged 18-45 years;
The patient or a close family member is capable of using a smartphone and mobile application (App);
Willing to participate in the study and able to provide written informed consent.
Severe cognitive impairment;
Advanced-stage malignancy;
Life expectancy less than 12 months;
Severe multi-organ failure;
Parallel
AI-Enabled Stratified Management System
Combination productAfter discharge, participants install SMART-CHD, sync their EHR data, and complete a 10-minute orientation. They then use the app's OCR-assisted surveys to report lifestyle, lab, and event data, while paired wearables stream continuous vitals. AI voice calls and a CRC-managed WeChat group deliver reminders and support. The app's embedded predictive models stratify them into risk tiers and generate tier-specific follow-up schedules. Personalized lifestyle modification guidance, dietary plans, and medication adjustment recommendations are generated by the platform's module. Automated alerts and teleconsultation options are triggered upon detection of high-risk signs or abnormal results, ensuring timely clinical intervention and enhanced secondary prevention.
Usual Post-Discharge Care
Combination productUsual discharge protocol comprising verbal and printed discharge instructions addressing medication schedules, follow-up timelines, and lifestyle optimization strategies.
Cardiovascular Composite Endpoint Events
A composite of all-cause death, myocardial infarction, stroke, and unplanned cardiovascular-related rehospitalization.
Individual components of cardiac events
All-cause death, myocardial infarction, stroke, and unplanned cardiovascular-related rehospitalization
LDL-C level
Low-density lipoprotein cholesterol level. Unit of Measure: mmol/L.
LDL-C Goal Attainment
Achieving LDL-C \< 1.8 mmol/L.
Blood pressure level
Systolic blood pressure and Diastolic blood pressure. Unit of Measure: mmHg.
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