Medtronic has released data from the ALERT trial, designed to address health disparities and undertreatment in structural heart care.
The study utilised Tempus Next, an AI-enabled care pathway platform that empowers providers to deliver the next step in a patient’s care journey. The software automatically identifies significant AS or MR patients who may meet guideline-indicated therapy criteria, but do not have a treatment plan in place. The study evaluated the impact of electronic health record notifications generated by Tempus Next.
Results show electronic clinician notifications (ECNs) significantly improve the timely evaluation and treatment of aortic stenosis (AS) and mitral regurgitation (MR), including treatment with transcatheter aortic valve implantation (TAVI).
Findings from the study, sponsored by Tempus, were presented at American College of Cardiology’s annual scientific session (ACC.26; 28–30 March, New Orleans, USA) and simultaneously published in the Journal of the American College of Cardiology (JACC).
“As clinicians, our priority is to ensure that patients with significant heart valve disease receive timely treatment. Untreated symptomatic severe aortic stenosis carries a high risk of mortality within two years, yet we continue to see significant undertreatment particularly among patients from racial and ethnic minority groups and those with certain haemodynamic profiles. This compromises our ability to scale life-saving valve interventions across health systems,” said Wayne Batchelor (Inova Health System, Fairfax, USA), steering committee chair of the ALERT study. “These findings highlight the value of real-time clinical alerts to accelerate diagnosis and specialist referral, helping ensure that more patients—regardless of race, ethnicity, geography, haemodynamics, or other factors—have access to guideline-directed, life-saving care.”
Using 765 clinicians ordering 2,016 echocardiograms across five US health systems encompassing 35 hospitals, the study met its primary endpoint, defined as time to surgical or transcatheter valve intervention followed by time to multidisciplinary heart team (MHT) clinic visit within 90 days after the index echocardiogram. The findings revealed that ECNs were 27% more effective at notifying clinicians about patient cardiovascular status than usual care (win ratio, 1.27; 95% CI, 1.05-1.54; p=0.007).
Key findings at 90 days include a 40% relative increase in valve intervention (13.4% vs. 9.6%; p=0.005) and a 27% increase in MHT evaluations (22.7% vs. 17.9%; p=0.005).
Data suggest white patients represent the majority (90%) of all TAVI procedures. Conversely, patients who are Black, Hispanic, Asian, or part of other racial groups are not being treated with TAVI at the same rates as white patients. Additionally, women with aortic stenosis continue to experience meaningful disparities in care, as they are less likely to be referred for timely evaluation and valve intervention compared to men, making improved access to minimally invasive options like TAVI especially critical. Existing evidence suggests that this minimally invasive option could result in less time in the hospital and a quicker recovery compared to open heart surgery.
“The ALERT trial reflects how we are building the future of structural heart care—one that is more connected, data‑driven, and focused on reaching patients earlier in their disease journey,” said Jorie Soskin, vice president of the Structural Heart business at Medtronic. “By helping clinicians identify patients sooner and connect them to care, technologies like AI‑enabled alerts have the potential to ensure more people can benefit from lifesaving therapies like TAVI, regardless of race, geography, or background. This work underscores our commitment to advancing structural heart care and the future of TAVI.”
