Comprehensive cardiac rehabilitation for patients following infective endocarditis: results of the randomized CopenHeartIE trial
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Key result
Comprehensive cardiac rehabilitation did not significantly improve mental health at six months compared with usual care in patients following infective endocarditis (MCS 44.6 vs 48.8 points, p=0.41).
Why the study?
Physical and mental deconditioning is common following infective endocarditis, but rehabilitation remains virtually unexplored in this population.
Does comprehensive cardiac rehabilitation improve mental health and physical capacity in patients following infective endocarditis?
Population
117 adults with left-sided or cardiac device endocarditis
Comparison
12 weeks of exercise and psycho-educational consultations vs usual care
Design
Randomized trial
Follow-up
6 months
Authors
Discussion
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Implication
Does not support routine cardiac rehabilitation after endocarditis; leaves open need for alternative strategies in future trials.
Study Design
Type
RCT (n=117)
Blinding
Single-blind (outcome assessors and data analysts blinded)
Randomization
Computer-generated allocation sequence with varying block sizes (1:1)
Multicenter
Yes
Structured PICO
Does comprehensive cardiac rehabilitation improve mental health and physical capacity in patients following infective endocarditis?
P
Population
117 adults (81% male, mean age 60) with left-sided or cardiac device infective endocarditis followed for 6 months.
I
Intervention
Comprehensive cardiac rehabilitation program consisting of 12 weeks of physical exercise training (three times weekly, aerobic and resistance) and five psycho-educational consultations.
C
Comparator
Usual care without standardized rehabilitation (one week and one month clinical follow up, including blood work, blood pressure, pulse, and temperature control).
O
Outcome
Mental health measured by SF-36 Mental Component Summary (MCS) at 6 months.patient reported
Main Result
Absolute Event Rate: 44.6% vs 48.8%
p-value: p=0.41
In patients recovering from infective endocarditis, a comprehensive cardiac rehabilitation program did not significantly improve mental health or physical capacity, though the trial was limited by low statistical power and poor adherence.
Limitations
- Low inclusion-rate resulting in trial-termination before reaching target sample size
- Lack of statistical power
- Poor adherence to the intervention (28%)
- Low inclusion rate resulting in trial termination before reaching target sample size (lack of statistical power)
Cite This Study
Rasmussen et al. (2021) conducted an RCT in Infective endocarditis (n=117). Comprehensive cardiac rehabilitation vs. Usual care was evaluated on Mental health measured by SF-36 Mental Component Summary (MCS) at six months (p=0.41). Comprehensive cardiac rehabilitation did not significantly improve mental health at six months compared with usual care in patients following infective endocarditis (MCS 44.6 vs 48.8 points, p=0.41).
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