Effectiveness of Cardiac Rehabilitation in Enhancing Adherence and Improving Clinical Outcomes Post-Acute Coronary Syndrome: A Randomized Controlled Trial

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-06-02 DOI:10.1002/clc.70160

Haşim Tüner, Fuat Polat, Enes Alıç, Ali Nail Kaya, Çiğdem Bahar Çakmak, Ferhat Coşkun, Emrah Özbek

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Abstract

Background

Acute coronary syndrome (ACS) remains a major contributor to cardiovascular morbidity and mortality. Cardiac rehabilitation programs have shown promise in improving adherence to lifestyle and medical recommendations, yet their impact on clinical outcomes and complications requires further investigation.

Methods

This prospective, randomized, single-center study evaluated the effects of cardiac rehabilitation on adherence and clinical outcomes in ACS patients. A total of 340 patients were randomized into a Cardiac Rehabilitation Group or Control Group. The Cardiac Rehabilitation Group underwent supervised exercise, dietary counseling, and education, while the Control Group received standard recommendations. Outcomes, including adherence rates and complications, were assessed over 1 year, with additional interim analyses to evaluate early sustainability of behavioral changes.

Results

Patients in the Cardiac Rehabilitation Group demonstrated significant improvements in adherence to dietary recommendations (73.5% vs. 52.4%, p < 0.01) and physical activity (85.3% vs. 68.2%, p < 0.01). Cardiac Rehabilitation Group patients also experienced fewer instances of weight gain (22.9% vs. 34.7%, p = 0.017) and access site complications (21.2% vs. 40%, p < 0.01). Hospital readmissions were reduced in the Cardiac Rehabilitation Group compared to the Control Group (18.8% vs. 31.2%, p = 0.015). Non-adherence to dietary recommendations (HR: 2.42, 95% CI: 1.08–5.41, p = 0.032) and medical treatments (HR: 2.84, 95% CI: 1.32–6.11, p = 0.007) were significantly associated with increased risk of revascularization.

Conclusion

Cardiac rehabilitation significantly enhances adherence to medical and lifestyle recommendations, reduces complications, and improves outcomes in ACS patients. These findings emphasize the critical role of structured rehabilitation in post-ACS management.

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心脏康复在急性冠脉综合征后增强依从性和改善临床结果的有效性：一项随机对照试验

背景：急性冠脉综合征（ACS）仍然是心血管疾病发病率和死亡率的主要原因。心脏康复计划在提高生活方式和医疗建议的依从性方面显示出希望，但它们对临床结果和并发症的影响需要进一步研究。方法本前瞻性、随机、单中心研究评估心脏康复对ACS患者依从性和临床结局的影响。340例患者随机分为心脏康复组和对照组。心脏康复组接受有监督的锻炼、饮食咨询和教育，而对照组接受标准建议。结果，包括依从率和并发症，在1年内进行评估，并进行额外的中期分析以评估行为改变的早期可持续性。结果心脏康复组患者对饮食建议的依从性（73.5% vs. 52.4%, p < 0.01）和身体活动（85.3% vs. 68.2%, p < 0.01）均有显著改善。心脏康复组患者体重增加（22.9% vs. 34.7%, p = 0.017）和通路并发症（21.2% vs. 40%, p < 0.01）也较少。与对照组相比，心脏康复组的再入院率降低（18.8%比31.2%,p = 0.015）。不遵守饮食建议（风险比：2.42,95% CI: 1.08-5.41, p = 0.032）和药物治疗（风险比：2.84,95% CI: 1.32-6.11, p = 0.007）与血管重建风险增加显著相关。结论心脏康复可显著提高ACS患者对医疗和生活方式建议的依从性，减少并发症，改善预后。这些发现强调了结构化康复在acs后管理中的关键作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.