Promoting active recovery: impact of a cardiac rehabilitation program on lifestyle and risk factor control after acute coronary syndrome

Background Secondary prevention following an acute coronary syndrome (ACS) includes multidisciplinary programs with exercise prescription, cardiovascular risk factor modification, and psychosocial and nutritional support. Purpose The aim of the study was to assess the impact of a structured cardiac rehabilitation program (CRP) on exercise activity habits and cardiovascular risk factors’ control. Methods A retrospective single-center study of patients who completed a CRP due to coronary artery disease between January 2025 and June 2025 was conducted. Comorbidities, number of CRP sessions, and parameters before and after CRP were registered: smoking status, physical activity habits (with at least 150 minutes per week of any intensity), blood pressure (BP), body mass index (BMI), abdominal waist, low-density lipoprotein (LDL) cholesterol levels and glycated hemoglobin. Chi-square test and Wilcoxon tests were used for statistical analysis. Results This study included 59 patients, 83.1% (n = 49) males, with a median age of 60 [17] years old. Only 3 patients kept smoking habits after ACS. Before CRP, 43 (72.9%) patients reported physical activity habits. CRP included a median of 21 [8] sessions. After the program, 54 (91.5%) of patients reported physical activity habits, being a significant increase (p = 0.017). Blood pressure did not significantly change after CRP (systolic BP of 129 [28] mmHg before versus 123 [17] mmHg after, p = 0.136; diastolic BP of 77 [13] mmHg to 77 [13] mmHg, p = 0.163). BMI and abdominal waist remained identical (p = 0.384 and p = 0.820, respectively). Only LDL cholesterol levels were significantly reduced during CRP (from 69 [73] mg/dL to 60 [27] mg/dL, p = 0.007). Glycated hemoglobin was similar prior and after CRP (5.8 [0.5] % to 5.9 [0.6] %, respectively). Conclusion Participation in a structured CRP after ACS was associated with a significant improvement in physical activity habits and a reduction in LDL cholesterol levels. Other cardiovascular risk factors, including blood pressure, body mass index, abdominal waist, and glycated hemoglobin, remained stable throughout the program. These findings suggest that while CRP effectively promotes lifestyle modification and lipid control, additional strategies focusing on weight management and metabolic optimization may enhance its overall impact on secondary prevention in patients with coronary artery disease.