Position Statement of the Italian Society of Cardiovascular Prevention (SIPREC) and Italian Heart Failure Association (ITAHFA) on Cardiac Rehabilitation and Protection Programs as a Cornerstone of Secondary Prevention after Myocardial Infarction or Revascularization

High Blood Press Cardiovasc Prev. 2024 Sep;31(5):417-423. doi: 10.1007/s40292-024-00663-z. Epub 2024 Jul 26.

Abstract

Despite the remarkable and progressive advances made in the prevention and management of cardiovascular diseases, the recurrence of cardiovascular events remains unacceptably elevated with a notable size of the residual risk. Indeed, in patients who suffered from myocardial infarction or who underwent percutaneous or surgical myocardial revascularization, life-style changes and optimized pharmacological therapy with antiplatelet drugs, lipid lowering agents, beta-blockers, renin angiotensin system inhibitors and antidiabetic drugs, when appropriate, are systematically prescribed but they might be insufficient to protect from further events. In such a context, an increasing body of evidence supports the benefits of cardiac rehabilitation (CR) in the setting of secondary cardiovascular prevention, consisting in the reduction of myocardial oxygen demands, in the inhibition of atherosclerotic plaque progression and in an improvement of exercise performance, quality of life and survival. However, prescription and implementation of CR programs is still not sufficiently considered.The aim of this position paper of the Italian Society of Cardiovascular Prevention (SIPREC) and of the Italian Heart Failure Association (ITAHFA) is to examine the reasons of the insufficient use of this strategy in clinical practice and to propose some feasible solutions to overcome this clinical gap.

Keywords: Cardiac rehabilitation; Cardiovascular prevention; Coronary artery disease; Myocardial infarction; Physical exercise.

Publication types

  • Practice Guideline

MeSH terms

  • Cardiac Rehabilitation* / standards
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use
  • Consensus*
  • Heart Disease Risk Factors
  • Heart Failure* / diagnosis
  • Heart Failure* / physiopathology
  • Humans
  • Italy
  • Myocardial Infarction* / prevention & control
  • Myocardial Infarction* / rehabilitation
  • Myocardial Infarction* / surgery
  • Myocardial Revascularization*
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Secondary Prevention* / methods
  • Secondary Prevention* / standards
  • Treatment Outcome

Substances

  • Cardiovascular Agents