Cardiac Prevention and Rehabilitation “3.0”: From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR)

Abstract

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives.

Referral from vascular surgery to cardiovascular rehabilitation and related outcomes in patients with peripheral arterial disease: the THINKPAD-RELOADED survey

“…The structured network was located in the Lombardy and Veneto regions of Italy, where LEPAD is considered by the Regional Health System as an appropriate and refundable condition both for residential and ambulatory CR [13]. The three primary endpoints of this THINKPAD-RELOADED prospective observational study were i) to analyse clinical characteristics and cardiovascular risk profile of patients referred ("CR group") and not referred ["usual care (UC) group"] by vascular surgery facilities to CR units; ii) to compare cardioprotective drugs and the achievement of secondary prevention targets between patients referred and not referred; and iii) to provide a 2-year follow-up for death from any cause, major adverse cardiovascular events and major adverse limb events in both groups.…”

Oncology and Cardiac Rehabilitation: An Underrated Relationship

“…The core component of CR and secondary prevention programs can be shared, being multi-factorial interventions, with cancer patients: health education, CV risk reduction, stress management, increased physical activity and exercise, healthy diet, optimization of drug therapy. The CR reduces mortality, morbidity and hospitalization, as well as improving exercise capacity, psychological wellbeing and QoL in patients with CVD [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].…”

Iron deficiency from the standpoint of cardiac rehabilitation: novel therapeutic opportunities

“…Cardiac rehabilitation is a multidisciplinary intervention aimed at improving the outcome in terms of both the quality of life and prognosis of patients suffering a broad range of cardiovascular disease including coronary heart disease, heart failure and valvular heart disease. The comprehensive approach of cardiac rehabilitation that, apart from exercise, include clinical stabilization, optimization of pharmacological and non-pharmacological treatment, management of comorbidities and treatment of disability, is increasingly being appreciated as a successful to manage the complexities of the rapidly growing population of elderly people with cardiovascular disease [1]. Iron deficiency (ID) and iron-deficiency anemia (IDA) are highly prevalent among patients entering cardiac rehabilitation programs and are associated with health implications (including physical decline, cognitive impairment, increased susceptibility to falling) that may add to the impairment of the underlying cardiovascular disease or may limit the use of advanced therapies, as in the examples listed below.…”