Cardiac Rehabilitation Improved Prognosis, Mental Health Outcomes

Cardiac rehabilitation is a valuable tool in the recovery of those with cardiac conditions across the spectrum. Posters presented at ASPC 2025 Congress on Cardiac Prevention, held in Boston from August 1 to August 3, 2025, confirm the utility of cardiac rehabilitation when it comes to improving physical and mental outcomes as well as improving mid- and long-term prognosis in those with acute coronary syndrome (ACS).^1,2

Cardiac rehabilitation is recommended for all ages with heart conditions. Specifically, those who benefit the most from cardiac rehabilitation include those who have had cardiac surgery or a heart procedure, a heart condition such as coronary artery disease or heart failure, or had a heart attack in the past.³ Those who believe themselves to be eligible can ask their primary care physician if they would benefit from participating in it. Rehab involves education on living in a heart-healthy manner, receiving counseling to reduce stress, and exercising in ways that promote heart health.⁴

Cardiac rehabilitation proved to be effective in improving outcomes in patients with cardiovascular disease | Image credit: serafino - stock.adobe.com

According to new research, this cardiac rehabilitation can be beneficial for both mid- and long-term prognoses for survivors of ACS.¹ The study used the National Myocardial Infarction Register of Hungary to conduct a retrospective analysis. The register contained data on 66,905 individuals who had early survivor ACS.

Across all participants, 21.2% participated in rehab. Those who participated had a 1-year mortality of 6.3% and a 5-year mortality of 20.1% compared with a 1-year mortality of 12.1% and a 5-year mortality of 30.4% in those who did not participate. Patients who had ST-Elevation Myocardial Infarction (STEMI) had a 28.9% participation in rehabilitation, with participants having a 1-year mortality of 4.7% and a 5-year mortality of 16.1% compared with a 1-year mortality of 9.1% and a 5-year mortality of 23.5% in those who did not participate.

Non-STEMI patients had an overall participation of 15.1%. Those who participated had a 1-year mortality of 8.7% and a 5-year mortality of 26.1% compared with a 1-year mortality of 14.1% and a 5-year mortality of 35.1% in those who did not participate.

The researchers concluded that cardiac rehabilitation had a significant survival benefit in those who participated, reducing mortality after both 1 year and 5 years. Low participation in rehab indicates that interventions to encourage participation should be introduced.

Not only is it beneficial for prognosis, but cardiac rehabilitation has also been found to have long-term benefits on both physical and mental health outcomes in those who participate in the process.² The aim of the study was to assess patients after they participated in cardiac rehabilitation to see if they had fewer symptoms, lower rates of depression, and increased activity levels. All patients were enrolled between May 2019 and November 2020. All participants completed surveys at the beginning of cardiac rehabilitation, and the Duke Activity Status Index was used to measure metabolic equivalents (METs). The Patient Health Questionnaire-9 was used to measure depressive symptoms. All participants were followed up 1 year after the completion of rehabilitation.

There were 200 participants enrolled initially and 82 who completed follow-up. Patients who graduated from cardiac rehabilitation had higher changes in depressive symptoms, seeing lower scores after a year compared with those who did not graduate. Those who graduated rehabilitation also had higher METs after 1 year compared with those who did not graduate.

A total of 24% of those who graduated returned to work, compared with 15% of those who did not graduate. Only 32% of those who graduated experienced shortness of breath or chest pain compared with 63% of those who did not graduate. Resting chest pain was about equal between those who did graduate (15%) and did not graduate (17%), but the ability to do daily activities was more common in those who graduated compared with those who did not (79% vs 69%).

The researchers concluded that fewer symptoms and a greater gain in METs were found in those who graduated cardiac rehabilitation. This study was done in a single center with low retention due to the COVID-19 pandemic, which limits the study results.

Despite any limitations, this research shows that doctors and patients should continue to prescribe and use cardiac rehabilitation as a resource to both recover from cardiac events on a long-term basis to improve their prognosis after acute coronary syndrome and also improve their mental health alongside physical health.

References

1. Sári C, Heesch CM, Andréka P. Participation in a comprehensive cardiac rehabilitation program improves mid- and long-term prognosis in survivors of acute coronary syndrome. Presented at ASPC 2025 Congress on CVD Prevention; August 1-3, 2025; Boston, MA. Poster S109

2. Bracewell N, Naik D, Simek S, Conti J, Keeley E. Long term physical and mental health outcomes in patients who participate in cardiac rehabilitation. Presented at ASPC 2025 Congress on CVD Prevention; August 1-3, 2025; Boston, MA. Poster S112

3. Am I eligible for cardiac rehab? American Heart Association. Updated April 24, 2024. Accessed July 31, 2025. https://www.heart.org/en/health-topics/cardiac-rehab/am-i-eligible-for-cardiac-rehab

4. What is cardiac rehabilitation? American Heart Association. Updated April 24, 2024. Accessed July 31, 2025. https://www.heart.org/en/health-topics/cardiac-rehab/what-is-cardiac-rehabilitation