Key result
Cardiac telerehabilitation matches inpatient rehabilitation for improving exercise capacity after acute coronary syndrome.
Why the study?
During the COVID-19 pandemic, cardiac rehabilitation availability was limited despite ACS patients requiring careful monitoring, prompting evaluation of whether remote CR achieved similar physical performance improvements as pre-pandemic centre-based CR.
Does remote cardiac telerehabilitation improve exercise capacity as effectively as inpatient rehabilitation in patients after acute coronary syndrome?
Cohort (n=419)
No
Does remote cardiac telerehabilitation improve exercise capacity as effectively as inpatient rehabilitation in patients after acute coronary syndrome?
Absolute Event Rate: 1.2% vs 1%
p-value: p=0.17
Remote cardiac telerehabilitation following an acute coronary syndrome provides a comparable improvement in exercise capacity to traditional inpatient rehabilitation, supporting its broader use.
Telerehabilitation may yield comparable exercise gains post-ACS; leaves open confirmation by randomized trials before practice change.
Introduction: During the COVID-19 pandemic, the availability of cardiac rehabilitation (CR) was limited. On the other hand, during that period of epidemic restrictions, patients with acute coronary syndrome (ACS) required careful control and monitoring after coronary events. The aim of this study was to assess whether CR conducted during the epidemic restrictions in a remote mode ensured similar improvement in physical performance as CR conducted in a centre-based mode before the COVID-19 pandemic. Material and Methods: In this one-centre study, we compared the demographic and clinical profiles of patients after ACS who completed inpatient CR before the COVID-19 era with those of patients who completed telerehabilitation during the COVID-19 pandemic. We assessed the workload on the initial and final exercise tests (ExT) obtained by patients and compared the values of the differences between the final and initial ExT. The study included 359 patients (pts) participating in inpatient CR before October 2020 (the suspension of centre-based CR) and 60 pts who took part in telerehabilitation after July 2021 (the introduction of the tele-CR programme). Both inpatient and tele-CR were performed according to the guidelines of the Working Group for Cardiac Rehabilitation of the National Cardiac Society. A telemedic platform was used to control ECG, blood pressure and body mass of the pts participating in telerehabilitation. Results: The improvement of physical performance did not differ significantly between the two groups. The pts who completed telerehabilitation were significantly older than those who completed inpatient CR. The values of other parameters, such as the percentage of females, BMI, the percentage of pts with arterial hypertension and type 2 diabetes mellitus, as well as left ventricular ejection fraction did not differ significantly between the compared groups. Nor did the results of initial ExT expressed in METs, the results of final ExT and the improvement of workload understood as the difference between the final and initial results of ExT differ significantly—they were 7.7 ± 3.06 vs. 7.89 ± 2.98 with p = 0.82; 9.08 ± 0.29 vs. 8.98 ± 3.48 with p = 0.84, and 1 [0–2.2] vs. 1.2 [0–1.8] with p = 0.17, respectively. Conclusions: In our centre, telerehabilitation after acute coronary syndrome guaranteed an equally good improvement in physical capacity as that observed in inpatient CR patients, regardless of the difference in the age profile of the compared groups. These results encourage the popularization of telerehabilitation with remote monitoring of ECG, blood pressure and body mass.
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Bralewska et al. (2025) conducted a cohort in Acute coronary syndrome (n=419). Cardiac telerehabilitation vs. Inpatient cardiac rehabilitation was evaluated on Improvement in physical capacity (difference between final and initial exercise test workload in METs) (p=0.17). Cardiac telerehabilitation after acute coronary syndrome yielded a similar median improvement in exercise capacity compared to traditional inpatient rehabilitation (1.2 METs vs 1.0 METs; p=0.17).
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