Browsing by Author "Polat, Fuat"

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    Article
    Effectiveness of Cardiac Rehabilitation in Enhancing Adherence and Improving Clinical Outcomes Post-Acute Coronary Syndrome: a Randomized Controlled Trial
    (Wiley, 2025) Tuner, Hasim; Polat, Fuat; Alic, Enes; Kaya, Ali Nail; Cakmak, Cigdem Bahar; Coskun, Ferhat; Ozbek, Emrah
    Background:Acute coronary syndrome (ACS) remains a major contributor to cardiovascular morbidity and mortality. Cardiacrehabilitation programs have shown promise in improving adherence to lifestyle and medical recommendations, yet theirimpact on clinical outcomes and complications requires further investigation. Methods:This prospective, randomized, single-center study evaluated the effects of cardiac rehabilitation on adherence andclinical outcomes in ACS patients. A total of 340 patients were randomized into a Cardiac Rehabilitation Group or ControlGroup. The Cardiac Rehabilitation Group underwent supervised exercise, dietary counseling, and education, while the ControlGroup received standard recommendations. Outcomes, including adherence rates and complications, were assessed over 1 year,with additional interim analyses to evaluate early sustainability of behavioral changes. Results:Patients in the Cardiac Rehabilitation Group demonstrated significant improvements in adherence to dietary rec-ommendations (73.5% vs. 52.4%,p< 0.01) and physical activity (85.3% vs. 68.2%,p< 0.01). Cardiac Rehabilitation Grouppatients also experienced fewer instances of weight gain (22.9% vs. 34.7%,p= 0.017) and access site complications (21.2% vs.40%,p< 0.01). Hospital readmissions were reduced in the Cardiac Rehabilitation Group compared to the Control Group (18.8%vs. 31.2%,p= 0.015). Non-adherence to dietary recommendations (HR: 2.42, 95% CI: 1.08-5.41,p= 0.032) and medical treat-ments (HR: 2.84, 95% CI: 1.32-6.11,p= 0.007) were significantly associated with increased risk of revascularization. Conclusion:Cardiac rehabilitation significantly enhances adherence to medical and lifestyle recommendations, reducescomplications, and improves outcomes in ACS patients. These findings emphasize the critical role of structured rehabilitation inpost-ACS management.
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    Impact of Cardiac Rehabilitation on Adherence to Secondary Prevention Measures Across STEMI, NSTEMI, and Unstable Angina Pectoris Subgroups: A Randomized Controlled Trial in High-Risk Patients
    (Taylor & Francis Ltd, 2025) Polat, Fuat; Tuner, Hasim; Cakmak, Cigdem Bahar; Ozbek, Emrah
    Background Acute coronary syndrome (ACS) patients with multiple cardiovascular risk factors face particularly high recurrence rates. The differential impact of cardiac rehabilitation across ACS subtypes in high-risk patients remains understudied. Methods This prospective, randomised, single-center study evaluated cardiac rehabilitation effects on adherence across ACS subtypes in high-risk patients. 260 patients with baseline smoking, BMI >= 25 kg/m(2), and physical inactivity were randomised 1:1 to cardiac rehabilitation or control groups. Patients were stratified by ACS type: STEMI, NSTEMI, and unstable angina pectoris (UAP). Primary outcomes included adherence to medical treatment, dietary recommendations, physical activity guidelines, smoking cessation, and weight management at one-year follow-up. Results Among 260 patients (130 rehabilitation, 130 control), NSTEMI was most common (45.4%), followed by STEMI (32.7%) and UAP (21.9%). Cardiac rehabilitation significantly improved adherence across all ACS subtypes. Overall adherence rates in rehabilitation vs. control groups were: medical treatment (89.2% vs. 71.5%, p < 0.001), dietary recommendations (82.3% vs. 58.5%, p < 0.001), physical activity (85.4% vs. 42.3%, p < 0.001), smoking cessation (76.9% vs. 43.1%, p < 0.001), and weight management (73.1% vs. 51.5%, p < 0.001). STEMI patients excelled in smoking cessation (84.7% vs. 38.6%), NSTEMI in physical activity (88.1% vs. 40.7%), and UAP in medical adherence (92.9% vs. 75.0%). All-cause rehospitalization rates were significantly lower in the rehabilitation group (12.3% vs. 23.1%, p = 0.023), as were cardiovascular-related rehospitalizations (7.7% vs. 18.5%, p = 0.012). Conclusion Structured cardiac rehabilitation significantly enhances adherence to all secondary prevention measures across STEMI, NSTEMI, and UAP subtypes in high-risk patients, with subtype-specific patterns of improvement.