Korean Circ J.  2019 Nov;49(11):1066-1111. 10.4070/kcj.2019.0194.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome

Affiliations
  • 1Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea.
  • 2Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine–Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea.
  • 3Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine–Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea.
  • 4Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 5Gyeonggi Regional Cardiocerebrovascular Center, Seongnam, Korea.
  • 6Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University College of Medicine, Cheongju, Korea. rmdr29@cbnuh.or.kr
  • 7Department of Rehabilitation Medicine, Chungnam National University College of Medicine–Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea.
  • 8Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.
  • 9Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea.
  • 10Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 11Department of Rehabilitation Medicine, Dongguk University School of Medicine, Goyang, Korea.
  • 12Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
  • 13Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 14Department and Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 15National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea.
  • 16Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
  • 17Namdarun Rehabilitation Clinic, Yongin, Korea.
  • 18Department of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University Medical Center, Seoul, Korea.
  • 19Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 20Department of Rehabilitation Medicine, Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Medical School & Hospital, Gwangju, Korea.
  • 21Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
  • 22Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
  • 23Department of Thoracic Surgery, Chungnam National University Hospital, Daejeon, Korea.
  • 24Department of Rehabilitation Medicine, Kangwon National University School of Medicine–Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea.
  • 25Department of Rehabilitation Medicine, Inha University Hospital, Incheon, Korea.
  • 26Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
  • 27Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 28Department of Rehabilitation Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
  • 29Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 30Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea.
  • 31Research Institute for Social Science, Ewha Woman's University, Seoul, Korea.

Abstract

Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors"”primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Keyword

Acute coronary syndrome; Cardiac rehabilitation; Mortality; Clinical practice guideline; Secondary prevention

MeSH Terms

Acute Coronary Syndrome*
Cause of Death
Consultants
Coronary Disease
Delivery of Health Care
Heart
Hospitals, General
Hospitals, University
Humans
Insurance Benefits
Korea*
Life Style
Methods
Mortality
Myocardial Infarction
Nutritionists
Physical Therapists
Preventive Medicine
Recurrence
Rehabilitation*
Secondary Prevention*
Specialization
Sports Medicine
Surgeons
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