In issue of the European Heart Journal, Doimo and colleagues provide a relatively large study to evaluate the long-term clinical impact of cardiac rehabilitation which adds important evidence to the issue and holds some important messages for our daily clinical practice. Firstly, cardiac rehabilitation works. This study demonstrates that participation in cardiac rehabilitation after ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), coronary artery bypass graft (CABG), or planned percutaneous coronary intervention (PCI) was independently associated with a reduction of the composite endpoint of hospitalizations for cardiovascular causes and cardiovascular mortality. A second important message of this trial is the fact that cardiac rehabilitation has to be implemented early after an event. Existing data have clearly demonstrated that a delay in starting cardiac rehabilitation may have a fatal impact on participation and adherence to such a programme. Аn early appointment leads to a significant 18% absolute and 56% relative improvement in adherence.Thirdly, lifelong adherence to physical exercise and cardiovascular risk factor control is crucial. Fourthly, cardiac rehabilitation is for everyone, and there should not be any age limitation. The study demonstrates exemplarily that elderly and even very old patients (>80 years) benefit from tailored lifestyle interventions. Fifthly, cardiac rehabilitation and lifestyle management are working in an ambulatory setting.
Eur Heart J. 2019;40(8):686-688.
