Clinical Outcomes of cardiac rehabilitation programs in Patients with coronary artery disease

Abstract

Cardiac rehabilitation is a structured, multidisciplinary secondary-prevention program combining supervised exercise training, risk-factor modification, psychosocial support, and patient education for patients with coronary artery disease. Despite strong guideline endorsement, referral, enrollment, and completion rates remain far below targets across most healthcare systems, leaving much of the intervention's demonstrated benefit unrealized at the population level. This review synthesizes clinical outcomes evidence for cardiac rehabilitation in coronary artery disease, covering mortality reduction, functional capacity and quality-of-life outcomes, program delivery models, access barriers, and cost-effectiveness. Randomized meta-analyses and large cohorts consistently show reduced cardiovascular mortality and readmission, dose-dependent benefit with greater session attendance, and durable improvements in exercise capacity, angina burden, and quality of life alongside contemporary revascularization and medical therapy. Home-based and hybrid delivery models now offer outcomes comparable to center-based programs for appropriately selected patients, and cost-effectiveness analyses place cardiac rehabilitation favorably against other established secondary-prevention therapies. The principal unresolved problem is implementation rather than efficacy: persistent underuse, geographic and demographic disparities in access, and markedly uneven global program availability. Automatic referral pathways, expanded home-based options, and sustained policy investment represent the most direct route to translating this evidence base into population-level reductions in coronary artery disease morbidity and mortality.