@article{SchwaabRauchVoelleretal.2020, author = {Schwaab, Bernhard and Rauch, Bernhard and V{\"o}ller, Heinz and Benzer, Werner and Schmid, Jean-Paul}, title = {Beyond randomised studies}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {28}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, number = {17}, publisher = {Oxford Univ. Press}, address = {Oxford}, issn = {2047-4873}, doi = {10.1177/2047487320936782}, pages = {E17 -- E19}, year = {2020}, language = {en} } @article{SalzwedelJensenRauchetal.2020, author = {Salzwedel, Annett and Jensen, Katrin and Rauch, Bernhard and Doherty, Patrick and Metzendorf, Maria-Inti and Hackbusch, Matthes and V{\"o}ller, Heinz and Schmid, Jean-Paul and Davos, Constantinos H.}, title = {Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {27}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, number = {16}, publisher = {Oxford Univ. Press}, address = {Oxford}, organization = {Univ Heidelberg Heinrich Heine Univ}, issn = {2047-4873}, doi = {10.1177/2047487320905719}, pages = {1756 -- 1774}, year = {2020}, abstract = {Background Despite numerous studies and meta-analyses the prognostic effect of cardiac rehabilitation is still under debate. This update of the Cardiac Rehabilitation Outcome Study (CROS II) provides a contemporary and practice focused approach including only cardiac rehabilitation interventions based on published standards and core components to evaluate cardiac rehabilitation delivery and effectiveness in improving patient prognosis. Design A systematic review and meta-analysis. Methods Randomised controlled trials and retrospective and prospective controlled cohort studies evaluating patients after acute coronary syndrome, coronary artery bypass grafting or mixed populations with coronary artery disease published until September 2018 were included. Resulte Based on CROS inclusion criteria out of 7096 abstracts six additional studies including 8671 patients were identified (two randomised controlled trials, two retrospective controlled cohort studies, two prospective controlled cohort studies). In total, 31 studies including 228,337 patients were available for this meta-analysis (three randomised controlled trials, nine prospective controlled cohort studies, 19 retrospective controlled cohort studies; 50,653 patients after acute coronary syndrome 14,583, after coronary artery bypass grafting 163,101, mixed coronary artery disease populations; follow-up periods ranging from 9 months to 14 years). Heterogeneity in design, cardiac rehabilitation delivery, biometrical assessment and potential confounders was considerable. Controlled cohort studies showed a significantly reduced total mortality (primary endpoint) after cardiac rehabilitation participation in patients after acute coronary syndrome (prospective controlled cohort studies: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; retrospective controlled cohort studies HR 0.64, 95\% CI 0.53-0.76; prospective controlled cohort studies odds ratio 0.20, 95\% CI 0.08-0.48), but the single randomised controlled trial fulfilling the CROS inclusion criteria showed neutral results. Cardiac rehabilitation participation was also associated with reduced total mortality in patients after coronary artery bypass grafting (retrospective controlled cohort studies HR 0.62, 95\% CI 0.54-0.70, one single randomised controlled trial without fatal events), and in mixed coronary artery disease populations (retrospective controlled cohort studies HR 0.52, 95\% CI 0.36-0.77; two out of 10 controlled cohort studies with neutral results). Conclusion CROS II confirms the effectiveness of cardiac rehabilitation participation after acute coronary syndrome and after coronary artery bypass grafting in actual clinical practice by reducing total mortality under the conditions of current evidence-based coronary artery disease treatment. The data of CROS II, however, underscore the urgent need to define internationally accepted minimal standards for cardiac rehabilitation delivery as well as for scientific evaluation.}, language = {en} } @article{HansenDendaleConinxetal.2017, author = {Hansen, Dominique and Dendale, Paul and Coninx, Karin and Vanhees, Luc and Piepoli, Massimo F. and Niebauer, Josef and Cornelissen, Veronique and Pedretti, Roberto and Geurts, Eva and Ruiz, Gustavo R. and Corra, Ugo and Schmid, Jean-Paul and Greco, Eugenio and Davos, Constantinos H. and Edelmann, Frank and Abreu, Ana and Rauch, Bernhard and Ambrosetti, Marco and Braga, Simona S. and Barna, Olga and Beckers, Paul and Bussotti, Maurizio and Fagard, Robert and Faggiano, Pompilio and Garcia-Porrero, Esteban and Kouidi, Evangelia and Lamotte, Michel and Neunhaeuserer, Daniel and Reibis, Rona Katharina and Spruit, Martijn A. and Stettler, Christoph and Takken, Tim and Tonoli, Cajsa and Vigorito, Carlo and V{\"o}ller, Heinz and Doherty, Patrick}, title = {The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {24}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, publisher = {Sage Publ.}, address = {London}, issn = {2047-4873}, doi = {10.1177/2047487317702042}, pages = {1017 -- 1031}, year = {2017}, abstract = {Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases.}, language = {en} }