B74-09 Comprehensive Cardiopulmonary Rehabilitation After Cabg and PCI: Effects on Functional Recovery, Respiratory Performance, and Long-Term Survival — A Systematic Review

Background myocardial perfusion is restored after Coronary revascularization through coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) but is usually followed by functional deconditioning and postoperative pulmonary dysfunction particularly after CABG. While cardiac rehabilitation (CR) improves cardiovascular outcomes, the benefits of integrating structured cardiopulmonary components—including respiratory muscle training and pulmonary physiotherapy—remain underexplored. This systematic review aimed to evaluate the effects of comprehensive cardiopulmonary rehabilitation on functional recovery, respiratory performance, and long-term survival in post-CABG and post-PCI patients. Methods A systematic search was conducted across PubMed, Embase, Cochrane Library, CINAHL, and Scopus from inception to October 2025. Eligible studies included randomized controlled trials (RCTs), quasi-experimental, and cohort studies comparing comprehensive cardiopulmonary rehabilitation (including aerobic exercise, inspiratory muscle training, and education) with standard care or conventional CR in adults after CABG or PCI. Primary outcomes were functional capacity (e.g., 6-minute walk distance [6MWD], VO2 max) and respiratory function (FEV1, FVC, maximal inspiratory/expiratory pressures). Secondary outcomes included mortality, hospital readmissions, and health-related quality of life (HRQoL). Data extraction followed PRISMA 2020 guidelines, and methodological quality was assessed using the Cochrane Risk-of-Bias tools. Results Twenty-three studies (n ≈ 5,400 participants) met inclusion criteria. Comprehensive cardiopulmonary rehabilitation significantly improved functional capacity (mean Δ 6MWD +68 m; 95% CI 45-91 m) and peak VO2 (Δ + 2.9 mL/kg/min; 95% CI 1.5-4.3). Subgroup analyses indicated that programs incorporating inspiratory muscle training led to greater gains in FEV1 and MIP, with a 15-25% increase over baseline compared with conventional CR. Long-term data (≥ 12 months) showed reduced all-cause mortality (pooled HR 0.72; 95% CI 0.58-0.89) and fewer readmissions among participants completing supervised cardiopulmonary rehabilitation. Evidence quality was moderate, limited by intervention heterogeneity and small sample sizes in some trials. Conclusions Integrating pulmonary-specific components within cardiac rehabilitation yields meaningful improvements in exercise tolerance, respiratory performance, and survival following CABG and PCI. These findings support a shift toward multidisciplinary cardiopulmonary rehabilitation models to optimize post-revascularization recovery and long-term outcomes. This abstract is funded by: None