The Impact of Lifestyle Intervention Programs on Long-Term Cardiac Event-Free Survival in Patients With Established Coronary Artery Disease

Coronary artery disease (CAD) is a leading global cause of morbidity and mortality, necessitating comprehensive approaches for its management. This systematic review evaluates the long-term impact of structured lifestyle intervention programs on cardiac event-free survival in patients with established CAD. A total of eight studies, including randomized controlled trials (RCTs) and prospective cohort studies, were analyzed, encompassing diverse interventions such as cardiac rehabilitation, dietary modifications, exercise programs, and psychosocial support. The findings indicate that lifestyle interventions significantly improve event-free survival, reduce recurrent cardiac events, and enhance overall health markers as compared to usual care. Intensive interventions, such as comprehensive cardiac rehabilitation, showed the most pronounced benefits, including regression of coronary artery stenosis measured through angiographic imaging and a reduced need for revascularization (relative risk reduction up to 45%; p < 0.05). Flexible and accessible approaches, like home-based or telephonic rehabilitation, demonstrated potential in improving adherence, measured by program completion rates and self-reported lifestyle changes, and outcomes in specific populations such as elderly or high-risk patients. Limitations include variability in intervention intensity, small sample sizes in some studies, and differences in adherence definitions and measurement methods. This review highlights the critical role of lifestyle modifications as a cornerstone of secondary prevention strategies in CAD management and suggests that technology-based and demographic-specific interventions may hold promise for improving long-term outcomes. Future research should focus on long-term sustainability and optimizing tailored intervention designs.