Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy.
IRCCS San Raffaele, Rome, 00166, Italy.
High Blood Press Cardiovasc Prev. 2024 Sep;31(5):417-423. doi: 10.1007/s40292-024-00663-z. Epub 2024 Jul 26.
Despite the remarkable and progressive advances made in the prevention and management of cardiovascular diseases, the recurrence of cardiovascular events remains unacceptably elevated with a notable size of the residual risk. Indeed, in patients who suffered from myocardial infarction or who underwent percutaneous or surgical myocardial revascularization, life-style changes and optimized pharmacological therapy with antiplatelet drugs, lipid lowering agents, beta-blockers, renin angiotensin system inhibitors and antidiabetic drugs, when appropriate, are systematically prescribed but they might be insufficient to protect from further events. In such a context, an increasing body of evidence supports the benefits of cardiac rehabilitation (CR) in the setting of secondary cardiovascular prevention, consisting in the reduction of myocardial oxygen demands, in the inhibition of atherosclerotic plaque progression and in an improvement of exercise performance, quality of life and survival. However, prescription and implementation of CR programs is still not sufficiently considered.The aim of this position paper of the Italian Society of Cardiovascular Prevention (SIPREC) and of the Italian Heart Failure Association (ITAHFA) is to examine the reasons of the insufficient use of this strategy in clinical practice and to propose some feasible solutions to overcome this clinical gap.
尽管在心血管疾病的预防和管理方面取得了显著而渐进的进展，但心血管事件的复发率仍然高得令人无法接受，而且残余风险显著。事实上，在患有心肌梗死或接受经皮或手术血运重建的患者中，生活方式的改变和优化的药物治疗，包括抗血小板药物、降脂药物、β受体阻滞剂、肾素-血管紧张素系统抑制剂和降糖药物（如适用），都被系统地开具处方，但这些可能不足以预防进一步的事件。在这种情况下，越来越多的证据支持心脏康复（CR）在二级心血管预防中的益处，包括降低心肌氧需求、抑制动脉粥样硬化斑块进展以及改善运动表现、生活质量和生存率。然而，CR 项目的开具和实施在临床实践中仍然没有得到充分考虑。意大利心血管预防学会（SIPREC）和意大利心力衰竭协会（ITAHFA）的这份立场文件旨在探讨在临床实践中未充分使用这一策略的原因，并提出一些可行的解决方案来克服这一临床差距。
