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Cardiac Rehabilitation — EECC MCQ

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ModerateCoronary Artery DiseaseCardiac RehabilitationEECC

A 63-year-old man had an anterior STEMI treated with primary PCI 4 weeks ago. He has been referred for cardiac rehabilitation. His LVEF is 40%. He is on bisoprolol 5 mg, ramipril 5 mg, dapagliflozin 10 mg, eplerenone 25 mg, aspirin 75 mg, ticagrelor 90 mg bd, and atorvastatin 80 mg. Which of the following is the strongest evidence-based benefit of cardiac rehabilitation in this patient?

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Correct answer: B — Reduction in cardiovascular mortality and hospital admissions

Exercise-based cardiac rehabilitation following MI is associated with a reduction in cardiovascular mortality and hospital admissions (Cochrane meta-analysis). While some earlier studies suggested all-cause mortality benefit, the most robust contemporary evidence supports CV mortality and hospitalisation reduction. Cardiac rehabilitation also improves exercise capacity, quality of life, and secondary prevention adherence. It does not directly prevent stent thrombosis or guarantee LVEF improvement of a specific magnitude. The ESC strongly recommends cardiac rehabilitation for all post-MI patients (Class I, LOE A).

Reference: ESC (2023): Guidelines for the Management of Acute Coronary Syndromes