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Title: SMARTphone-based, early cardiac REHABilitation in patients with acute coronary syndromes: a randomized controlled trial.
Austin Authors: Yudi, Matias B ;Clark, David J ;Tsang, David;Jelinek, Michael;Kalten, Katie;Joshi, Subodh;Phan, Khoa;Ramchand, Jay ;Nasis, Arthur;Amerena, John;Koshy, Anoop N ;Murphy, Alexandra C ;Arunothayaraj, Sandeep;Si, Si;Reid, Chris;Farouque, Omar 
Affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia
Department of Medicine, University of Melbourne
Department of Cardiology, St Vincent's Hospital
Department of Cardiology, Western Health
Department of Cardiology, Royal Melbourne Hospital
Monash Heart, Monash Health, Melbourne
Department of Cardiology, Barwon Health, Geelong
Department of Cardiology, St Vincent's Hospital
Issue Date: 27-Aug-2020 2020-08-27
Publication information: Coronary Artery Disease 2020; online first: 27 August
Abstract: There are well-documented treatment gaps in secondary prevention of coronary heart disease with a lack of clearly defined strategies to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps. The primary goal of this study was to assess whether a smartphone-based, early cardiac rehabilitation program improved exercise capacity in patients with ACS. A total of 206 patients with ACS across six tertiary Australian hospitals were included in this randomized controlled trial. Participants were randomized to usual care (UC; including referral to traditional cardiac rehabilitation), with or without an adjunctive smartphone-based cardiac rehabilitation program (S-CRP) upon hospital discharge. The primary endpoint was change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline, between groups. Secondary endpoints included uptake and adherence to cardiac rehabilitation, changes in cardiac risk factors, psychological well-being and quality of life status. Of the 168 patients with complete follow-up (age 56 ± 10 years; 16% females), 83 were in the S-CRP. At 8-week follow-up, the S-CRP group had a clinically significant improvement in 6-minute walk test distance (Δ117 ± 76 vs. Δ91 ± 110 m; P = 0.02). Patients in the S-CRP were more likely to participate (87% vs. 51%, P < 0.001) and adhere (72% vs. 22%, P < 0.001) to a cardiac rehabilitation program. Compared to UC, patients receiving S-CRP had similar smoking cessation rates, LDL-cholesterol levels, blood pressure reduction, depression, anxiety and quality of life measures (all P = NS). In patients with ACS, a S-CRP, as an adjunct to UC improved exercise capacity at 8 weeks in addition to participation and adherence to cardiac rehabilitation (Australian New Zealand Clinical Trials Registry; ACTRN12616000426482).
DOI: 10.1097/MCA.0000000000000938
Journal: Coronary Artery Disease
PubMed URL: 32868661
Type: Journal Article
Appears in Collections:Journal articles

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