Cardiac Telerehabilitation After an Acute Coronary Syndrome Ensures Similar Improvement in Exercise Capacity as Inpatient Rehabilitation, Regardless of the Age Profile of the Compared Groups

During the COVID-19 pandemic, the availability of cardiac rehabilitation (CR) was lim-ited. On the other hand, during that period of epidemic hazard, patients after acute cor-onary syndromes (ACS) required careful control and ensuring their improvement after the coronary event. The aim of this study was to assess whether CR conducted during the epidemic threat in a remote mode ensured similar improvement in physical per-formance as CR conducted in a centre-based mode before the COVID-19 pandemic. Material and methods: In this one-centre study, we compared the demographic and clinical profiles of patients after ACS who completed inpatient CR before the COVID-19 era with those of patients who completed telerehabilitation during the COVID-19 pan-demic. We assessed the workload on the initial and final exercise tests (ExT) obtained by patients and compared the values of the differences between the final and initial ExT. The study included 359 patients (pts) participating in inpatient CR before October 2020 (the suspension of centre-based CR) and 60 pts who took part in telerehabilitation after July 2021 (the introduction of the tele-CR programme). Both inpatient and tele- CR were performed according to the guidelines of the Working Group for Cardiac Rehabil-itation of the National Cardiac Society. A telemedic platform was used to control ECG, blood pressure and body mass of the pts participating in telerehabilitation. Statistical analysis included the Mann-Whitney U test, Student’s t-test and chi-square test. Results: The improvement of physical performance did not differ significantly between the two groups. The pts who completed telerehabilitation were significantly older than those who completed inpatient CR. The values of other parameters, such as the percentage of females, BMI, the percentage of pts with arterial hypertension and type 2 diabetes mellitus, as well as left ventricular ejection fraction did not differ significantly between the compared groups. Nor did the results of initial ExT expressed in METs, the results of final ExT and the improvement of workload understood as the difference between the final and initial results of ExT differ significantly – they were 7,7±3,06 vs 7,89±2,98 with p=0,82; 9,08±,29 vs 8,98±3,48 with p=0,84, and 1[0-2,2] vs 1,2[0-1,8] with p=0,17, respec-tively. Conclusions: In our centre, telerehabilitation after acute coronary syndrome guaranteed an equally good improvement in physical capacity as that observed in inpatient CR pa-tients, regardless of the difference in the age profile of the compared groups. These re-sults encourage the popularization of the cardiac rehabilitation mode with the remote monitoring of the ECG, blood pressure and body mass.