What does this research mean for the field?

Participation in cardiac rehabilitation reduced hospitalization for worsening heart failure by 46% (HR 0.538) in older patients with cardiovascular disease before the COVID-19 pandemic. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This study aims to assess the impact of cardiac rehabilitation on older patients with cardiovascular disease before, during, and after the COVID-19 pandemic.

February 12, 2026Geriatrics and gerontology international/Geriatrics & gerontology international

Prognostic Impact of Cardiac Rehabilitation in Older Patients With Cardiovascular Disease: A Three‐Period Analysis Around the COVID ‐19 Pandemic

Q: What are the key findings of this study?

Cardiac rehabilitation reduced hospitalization for worsening heart failure in older CVD patients before COVID-19 (HR 0.538, p=0.043) but impact was disrupted during the pandemic.

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Key result

CR linked to ~46% fewer HF hospitalizations pre-COVID, but the pandemic disrupted this benefit.

HR 0.538
p=0.043

Why the study?

During the COVID-19 pandemic, patients experienced difficulty attending in-hospital cardiac rehabilitation, motivating an investigation into the impact of cardiac rehabilitation in older CVD patients across pandemic periods.

Does a 4-month outpatient cardiac rehabilitation program reduce hospitalization for worsening HF in older patients with cardiovascular disease?

Key Points

This study aims to assess the impact of cardiac rehabilitation on older patients with cardiovascular disease before, during, and after the COVID-19 pandemic.
Post hoc analysis of a single-center registry involving 505 patients aged ≥ 65 years.
Comparison of outcomes based on participation in a 4-month outpatient cardiac rehabilitation program.
Categorization of patients into three periods: before, during, and after the COVID-19 pandemic.
Cumulative hospitalization for worsening heart failure was significantly lower in the cardiac rehabilitation group across all periods.
Cumulative non-cardiovascular event-free survival was significantly higher before and after the pandemic for the rehabilitation group.
No significant difference in non-cardiovascular events during the pandemic, and the association with hospitalization for heart failure was lost.

Structured PICO

Does a 4-month outpatient cardiac rehabilitation program reduce hospitalization for worsening HF in older patients with cardiovascular disease?

Population

505 patients aged ≥ 65 years (mean age 82) with cardiovascular disease (CVD) from a single-center registry, categorized into three periods: before the COVID-19 pandemic (n=173), during the COVID-19 pandemic (n=217), and after the COVID-19 pandemic (n=105).

Intervention

4-month outpatient cardiac rehabilitation (CR) program after discharge

Comparator

Non-participants in the cardiac rehabilitation program

Outcome

Cumulative hospitalization for worsening HFhard clinical

Outpatient cardiac rehabilitation is associated with reduced hospitalization for worsening heart failure in older patients with cardiovascular disease, though the COVID-19 pandemic attenuated the strength of this association.

Implication

CR was associated with lower HF hospitalization pre-pandemic in older CVD patients; leaves open durability and need for prospective confirmation.

Abstract

Aim During the COVID‐19 pandemic, some patients experienced difficulty attending regular in‐hospital cardiac rehabilitation (CR) after discharge. This study investigated the impact of CR in older patients with cardiovascular disease (CVD) by comparing outcomes before, during, and after the COVID‐19 pandemic. Methods In this post hoc analysis of a single‐center registry, 505 patients aged ≥ 65 years (mean age 82) were included. Outcomes were compared between participants in a 4‐month outpatient CR program after discharge and non‐participants. Patients were categorized into three periods: before the COVID‐19 pandemic ( n = 173), during the COVID‐19 pandemic ( n = 217), and after the COVID‐19 pandemic ( n = 105). Cardiovascular (CV) events and non‐CV events were followed. Results As the primary endpoint, cumulative hospitalization for worsening HF was significantly lower in the CR group across all time periods ( p < 0.001, p < 0.001, and p = 0.019, respectively). Cumulative non‐CV event‐free survival was significantly higher in the CR group before and after the COVID‐19 pandemic ( p < 0.001, p = 0.030, respectively) but showed no significant differences during the pandemic. Before the pandemic, participation in CR was significantly associated with hospitalization for worsening HF (hazard ratio [HR], 0.538; 95% confidence interval [CI], 0.294–0.982; p = 0.043). During and after the pandemic, this association was not. Conclusion CR appears to have a protective effect against CV events in older patients with CVD. Although the COVID‐19 pandemic disrupted this positive trend, the findings support CR as a cornerstone of recovery in this population.

Discussion

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Cite This Study

Hirashiki et al. (2026) studied this question. Cardiac rehabilitation reduced hospitalization for worsening heart failure in older CVD patients before COVID-19 (HR 0.538, p=0.043) but impact was disrupted during the pandemic.

synapsesocial.com/papers/698d6f5f5be6419ac0d552c3 https://doi.org/10.1111/ggi.70395