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Abstract

Objective Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Principal Conclusions CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Validation of FRIEND and ACSM Equations for Cardiorespiratory Fitness: Comparison to Direct Measurement in CAD Patients

“…For this reason, exercise-based CR is strongly recommended for CAD patients to achieve healthy lifestyle and risk factor management [ 27 ]. The ultimate objective of CR is to improve patients’ life quality by restoring CRF [ 28 ]. In addition, the improvement of CRF is associated with a significant reduction of future cardiovascular fatal and nonfatal events, independent of other risk factors [ 29 ].…”

Underutilization of Hospital-based Cardiac Rehabilitation after Acute Myocardial Infarction in Korea

“…Despite the recommendations accentuating the role of CR in AMI patients, 4 5 6 only 1.5% of these patients participated in the CR program in Korea. There was geographical variance in participation, ranging from 0.0% to 6.4%.…”

“…Current indications for CR are broader, including other cardiovascular diseases such as unstable angina, valvular heart disease, heart failure, and peripheral arterial diseases. 5 6 40 41 Therefore, the possibility of unrevealed demand for CR exists. Further studies, including these group of patients, are needed.…”

“… 1 With an improvement in survival after IHD, 2 more efforts are being channeled towards secondary prevention. 3 Cardiac rehabilitation (CR), an aspect of secondary prevention program, is highly recommended after IHD in national clinical practice guidelines, 4 5 6 (based on the evidence of CR) for improving clinical outcomes. 7 8 9 Nevertheless, CR participation rate after IHD has been low and shows disparities between countries 10 and individuals on account of various barriers.…”

Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study

“…Cardiovascular mortality has been shown to be significantly reduced in patients who underwent cardiac rehabilitation than in no-exercise controls [3]. In South Korea, the clinical guidelines for cardiac rehabilitation have recently been published to promote cardiac rehabilitation [4]. Nevertheless, the participation rate in cardiac rehabilitation programs is generally low despite the proven effectiveness of cardiac rehabilitation.…”