{ "abstract": "To review the effects of cardiac rehabilitation (CR) in patients with acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) and in mixed populations treated with contemporary interventional, surgical and pharmacological therapy. A systematic review and meta-analysis (PROSPERO CRD42025630588) including randomized controlled trials (RCT) and prospective/retrospective controlled cohort studies (pCCS/rCCS) was performed with total mortality as main endpoint. Additional endpoints were cardiovascular mortality, non-fatal cardiovascular events, and hospital readmissions. Subgroup analysis was performed for age and sex. From 40 included studies, 29 studies encompassing 308 514 patients were eligible for this meta-analysis, including 5 newly identified (published between 11/2018-09/2025) studies with 92 571 patients. In pCCS and rCCS, CR-participation was associated with significantly reduced total mortality in patients with ACS (n = 41 740; pCCS: HR 0.33, 95% CI 0.15-0.69; rCCS: HR 0.64, 95% CI 0.55-0.75) and with CABG (n = 17 998; rCCS: HR 0.65, 95% CI 0.56-0.76). The effects regarding total mortality were similar in sex and age subgroups. Cardiovascular mortality and non-fatal stroke were decreased in ACS and CABG patients. In mixed populations, CR was associated with reduced hospital readmissions for any reason and for any cardiovascular event. Methodological and structural heterogeneity and low patient numbers prevented robust results. Based on observational data, participation in CR is associated with an improved prognosis in current patients after ACS, CABG and mixed populations, similarly for sex and age subgroups. Hence, CR should be an integral part of secondary prevention in those patients. Nevertheless, high-quality studies are needed to increase the CR evidence base further.", "abstract_shown": true, "affiliations": [ "German Society of Prevention and Rehabilitation of Cardiovascular Diseases, Friedrich-Ebert-Ring 38, 56068 Koblenz, Germany.", "Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.", "Department of Preventive and Rehabilitative Sport and Exercise Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.", "Medical Faculty, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Germany.", "German Pension Insurance Braunschweig-Hannover, Lange Weihe 6, 30880 Laatzen, Germany.", "Curschmann Klinik, Rehabilitation Hospital for Cardiac and Vascular Diseases and Diabetes, Saunaring 6, 23669 Timmendorfer Strand, Germany.", "Medical Faculty, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.", "Cardiology Division, Geneva University Hospitals, Rue gabrielle-perret-gentil 4, 1204 Geneva, Switzerland.", "Medicine Campus Davos, Hochgebirgsklinik Davos, Herman-Burchard-Strasse 1, 7265 Davos Wolfgang, Switzerland.", "Department of Sports and Exercise Medicine, Faculty of Medicine, Karl Landsteiner University, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.", "Institute of Clinical Sports Medicine and Prevention, University Hospital Krems - NOE LGA, Mitterweg 10, 3500 Krems, Austria.", "Institute of General Practice, Centre for Health and Society, Medical Faculty of the Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf.", "Institut für Herzinfarktforschung, Bremserstr. 79, 67063 Ludwigshafen, Germany.", "Department of Internal Medicine, Klinik Gais AG, Gäbrisstrasse 1172, 9056 Gais, Switzerland.", "University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland.", "Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, 4 Soranou Ephessiou Street, 11257 Athens, Greece." ], "article_type": "research article", "arxiv": null, "author_total": 16, "authors": [ { "affs": [ 0 ], "name": "Annett Salzwedel", "orcid": "0000-0003-2530-2673" }, { "affs": [ 1 ], "name": "Johannes A Vey" }, { "affs": [ 2 ], "name": "Birna Bjarnason-Wehrens", "orcid": "0000-0002-8886-3999" }, { "affs": [ 3, 4 ], "name": "Axel Schlitt", "orcid": "0000-0002-3956-3519" }, { "affs": [ 5, 6 ], "name": "Bernhard Schwaab", "orcid": "0000-0003-4801-1107" }, { "affs": [ 7 ], "name": "Elena Tessitore", "orcid": "0000-0003-1680-0152" }, { "affs": [ 1 ], "name": "Amina Cheikh Rouhou", "orcid": "0009-0003-2870-3314" }, { "affs": [ 8 ], "name": "David Niederseer", "orcid": "0000-0003-3089-1222" }, { "affs": [ 9, 10 ], "name": "Mahdi Sareban", "orcid": "0000-0002-8146-0505" }, { "affs": [ 8 ], "name": "Greta Hametner", "orcid": "0009-0007-0152-5852" }, { "affs": [ 11 ], "name": "Maria-Inti Metzendorf", "orcid": "0000-0002-4154-5782" }, { "affs": [ 8 ], "name": "Gloria Petrasch" }, { "affs": [ 12 ], "name": "Steffen Schneider", "orcid": "0000-0001-9375-4861" }, { "affs": [ 13, 14 ], "name": "Jean-Paul Schmid", "orcid": "0000-0002-9008-8274" }, { "affs": [ 12 ], "name": "Bernhard Rauch", "orcid": "0000-0003-2391-8466" }, { "affs": [ 15 ], "name": "Constantinos H Davos", "orcid": "0000-0002-0321-7569" } ], "bibtex": "https://research.draconitic.com/paper/0k8jxzkb4sm8t.bib", "cited_by": 0, "doi": "10.1093/ehjopen/oeag152", "fulltext_url": "https://europepmc.org/articles/PMC13714604", "id": "0k8jxzkb4sm8t", "issns": [ "2752-4191" ], "landing_url": "https://europepmc.org/article/MED/42953095", "language": "eng", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "AcademicSubjects/MED00200" ], [ "heading", "Eurheartj/15" ], [ "heading", "Eurheartj/17" ], [ "heading", "Eurheartj/45" ], [ "heading", "Eurheartj/46" ], [ "heading", "Interventional Cardiology and Cardiac Surgery" ], [ "heading", "Original Article" ], [ "openalex", "2705|Cardiac Health and Mental Health" ] ], "openalex": "W7221366181", "pdf_url": "https://europepmc.org/articles/PMC13714604?pdf=render", "pmcid": "PMC13714604", "pmid": "42953095", "published": "2026-09-01", "publisher": "Oxford University Press", "ris": "https://research.draconitic.com/paper/0k8jxzkb4sm8t.ris", "sources": [ { "first_seen": "2026-10-31T00:20:41Z", "native_id": "MED:42953095", "source": "europepmc", "url": "https://europepmc.org/article/MED/42953095" }, { "first_seen": "2026-11-01T12:22:04Z", "native_id": "PMC13714604", "source": "pmc", "url": "https://doi.org/10.1093/ehjopen/oeag152" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Cardiac Health and Mental Health", "subfield": "cardiovascular" } ], "title": "Beneficial effects of cardiac rehabilitation after acute coronary syndrome and coronary artery bypass grafting: Real-world evidence from the Cardiac Rehabilitation Outcome Study update (CROS-III).", "title_text": "Beneficial effects of cardiac rehabilitation after acute coronary syndrome and coronary artery bypass grafting: Real-world evidence from the Cardiac Rehabilitation Outcome Study update (CROS-III).", "type": "peer-reviewed", "updated_at": "2026-11-01T12:22:04Z", "url": "https://research.draconitic.com/paper/0k8jxzkb4sm8t", "venue": "European heart journal open", "versions": [] }