Digital health interventions for lipid management in atherosclerotic cardiovascular disease: a systematic review and meta-analysis of randomised controlled trials

Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality worldwide. Lipid management is a key component of secondary prevention, but the majority of patients fail to achieve low-density lipoprotein cholesterol (LDL-c) goals. Digital health may serve as an innovative and cost-effective approach to improve lipid control, but a systematic quantitative synthesis is lacking. This study aimed to evaluate the effect of digital health interventions on LDL-c reduction and lipid target attainment in patients with ASCVD. Methods: statistic, and publication bias was assessed by visual inspection of a funnel plot and Egger's test. The Cochrane Risk of Bias 2 was used to evaluate risk of bias. The protocol was registered with PROSPERO (CRD42024575196). Findings: = 18%]. Interpretation: Our findings suggest that digital health interventions can support LDL-c reduction and lipid control in patients with ASCVD. Multi-component interventions were most effective, particularly when combined with high-frequency delivery, bidirectional communication, and telemonitoring. High heterogeneity and high risk of bias were observed across studies, and LDL-c reduction was not a primary outcome in most trials, warranting careful interpretation. Nevertheless, digital health shows potential for integration in lipid management, and warrants future research to optimise effectiveness and support implementation in clinical practice. Funding: Innovative Health Initiative Joint Undertaking.