{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:47:19Z","timestamp":1782449239205,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neth Heart J"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Cardiac rehabilitation (CR) has favourable effects on cardiovascular mortality and morbidity. Therefore, it might reasonable to expect that incomplete CR participation will result in suboptimal patient outcomes.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We studied the 914 post-acute coronary syndrome patients who participated in the OPTImal CArdiac REhabilitation (OPTICARE) trial. They all started a\u00a0\u2018standard\u2019 CR programme, with physical exercises (group sessions) twice a\u00a0week for 12\u00a0weeks. Incomplete CR was defined as participation in &lt;75% of the scheduled exercise sessions. Patients were followed-up for 2.7 years, and the incidence of cardiac events was recorded. Major adverse cardiac events (MACE) included all-cause mortality, non-fatal myocardial infarction and coronary revascularisation.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A\u00a0total of 142 (16%) patients had incomplete CR. They had a\u00a0higher incidence of MACE than their counterparts who completed CR (11.3% versus 3.8%, adjusted hazard ratio [aHR] 2.86 and 95% confidence interval [CI] 1.47\u20135.26). Furthermore, the incidence of any cardiac event, including MACE and coronary revascularisation, was higher (20.4% versus 11.0%, aHR 1.54; 95% CI 0.98\u20132.44). Patients with incomplete CR were more often persistent smokers than those who completed CR (31.7% versus 11.5%), but clinical characteristics were similar otherwise.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Post-ACS patients who did not complete a\u00a0\u2018standard\u2019 12-week CR programme had a\u00a0higher incidence of adverse cardiac events during long-term follow-up than those who completed the programme. Since CR is proven beneficial, further research is needed to understand the reasons why patients terminate prematurely.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s12471-020-01413-1","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T15:02:30Z","timestamp":1584716550000},"page":"460-466","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Patients who do not complete cardiac rehabilitation have an increased risk of cardiovascular events during long-term follow-up"],"prefix":"10.1007","volume":"28","author":[{"given":"M.","family":"Sunamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"ter Hoeve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J. G.","family":"van den Berg-Emons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Boersma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. L.","family":"Geleijnse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. T.","family":"van Domburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"issue":"20","key":"1413_CR1","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1093\/eurheartj\/ehs215","volume":"33","author":"PG Steg","year":"2012","unstructured":"Steg\u00a0PG, James\u00a0SK, Atar\u00a0D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart\u00a0J. 2012;33(20):2569\u2013619.","journal-title":"Eur Heart J"},{"issue":"23","key":"1413_CR2","doi-asserted-by":"publisher","first-page":"2432","DOI":"10.1016\/j.jacc.2011.10.824","volume":"58","author":"SC Smith Jr.","year":"2011","unstructured":"Smith\u00a0SC Jr., Benjamin\u00a0EJ, Bonow\u00a0RO, et\u00a0al. AHA\/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a\u00a0guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J\u00a0Am Coll Cardiol. 2011;58(23):2432\u201346. https:\/\/doi.org\/10.1016\/j.jacc.2011.10.824.","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"1413_CR3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.2459\/JCM.0b013e32834d4571","volume":"13","author":"LE Dobson","year":"2012","unstructured":"Dobson\u00a0LE, Lewin\u00a0RJ, Doherty\u00a0P, et\u00a0al. Is cardiac rehabilitation still relevant in the new millennium? J\u00a0Cardiovasc Med (Hagerstown). 2012;13(1):32\u20137.","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"1413_CR4","first-page":"CD001800","volume":"7","author":"BS Heran","year":"2011","unstructured":"Heran\u00a0BS, Chen\u00a0JM, Ebrahim\u00a0S, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2011;7:CD1800.","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"1413_CR5","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1161\/CIRCULATIONAHA.111.066738","volume":"126","author":"BJ Martin","year":"2012","unstructured":"Martin\u00a0BJ, Hauer\u00a0T, Arena\u00a0R, et\u00a0al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation. 2012;126(6):677\u201387.","journal-title":"Circulation"},{"key":"1413_CR6","first-page":"CD007131","volume":"6","author":"KN Karmali","year":"2014","unstructured":"Karmali\u00a0KN, Davies\u00a0P, Taylor\u00a0F, et\u00a0al. Promoting patient uptake and adherence in cardiac rehabilitation. Cochrane Database Syst Rev. 2014;6:CD7131.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"1413_CR7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.jacc.2009.01.078","volume":"54","author":"JA Suaya","year":"2009","unstructured":"Suaya\u00a0JA, Stason\u00a0WB, Ades\u00a0PA, et\u00a0al. Cardiac rehabilitation and survival in older coronary patients. J\u00a0Am Coll Cardiol. 2009;54(1):25\u201333.","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"1413_CR8","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1136\/heartjnl-2012-303022","volume":"99","author":"A Beauchamp","year":"2013","unstructured":"Beauchamp\u00a0A, Worcester\u00a0M, Ng\u00a0A, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart. 2013;99(9):620\u20135.","journal-title":"Heart"},{"issue":"4","key":"1413_CR9","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1007\/s00125-015-3491-1","volume":"58","author":"MJ Armstrong","year":"2015","unstructured":"Armstrong\u00a0MJ, Sigal\u00a0RJ, Arena\u00a0R, et\u00a0al. Cardiac rehabilitation completion is associated with reduced mortality in patients with diabetes and coronary artery disease. Diabetologia. 2015;58(4):691\u20138.","journal-title":"Diabetologia"},{"issue":"8","key":"1413_CR10","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1177\/2047487314545279","volume":"22","author":"JD Colbert","year":"2015","unstructured":"Colbert\u00a0JD, Martin\u00a0BJ, Haykowsky\u00a0MJ, et\u00a0al. Cardiac rehabilitation referral, attendance and mortality in women. Eur J Prev Cardiol. 2015;22(8):979\u201386.","journal-title":"Eur J Prev Cardiol"},{"issue":"8","key":"1413_CR11","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1136\/heartjnl-2011-300302","volume":"98","author":"RR West","year":"2012","unstructured":"West\u00a0RR, Jones\u00a0DA, Henderson\u00a0AH. Rehabilitation after myocardial infarction trial (RAMIT): multi-centre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction. Heart. 2012;98(8):637\u201344.","journal-title":"Heart"},{"issue":"6","key":"1413_CR12","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/j.amjmed.2014.02.008","volume":"127","author":"SM Dunlay","year":"2014","unstructured":"Dunlay\u00a0SM, Pack\u00a0QR, Thomas\u00a0RJ, et\u00a0al. Participation in cardiac rehabilitation, readmissions, and death after acute myocardial infarction. Am J Med. 2014;127(6):538\u201346.","journal-title":"Am J Med"},{"issue":"24","key":"1413_CR13","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1093\/eurheartj\/ehv111","volume":"36","author":"H de Vries","year":"2015","unstructured":"de Vries\u00a0H, Kemps\u00a0HM, van Engen-Verheul\u00a0MM, et al. Cardiac rehabilitation and survival in a\u00a0large representative community cohort of Dutch patients. Eur Heart\u00a0J. 2015;36(24):1519\u201328.","journal-title":"Eur Heart J"},{"issue":"7\u20138","key":"1413_CR14","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s12471-013-0422-y","volume":"21","author":"M Sunamura","year":"2013","unstructured":"Sunamura\u00a0M, Ter Hoeve\u00a0N, van den Berg-Emons\u00a0HJ, et al. OPTImal CArdiac REhabilitation (OPTICARE) following acute coronary syndromes: rationale and design of a\u00a0randomised, controlled trial to investigate the benefits of expanded educational and behavioural intervention programs. Neth Heart\u00a0J. 2013;21(7\u20138):324\u201330.","journal-title":"Neth Heart J"},{"issue":"5","key":"1413_CR15","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1136\/heartjnl-2017-311681","volume":"104","author":"M Sunamura","year":"2018","unstructured":"Sunamura\u00a0M, Ter Hoeve\u00a0N, van den Berg-Emons\u00a0RJG, et al. Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes. Heart. 2018;104(5):430\u20137.","journal-title":"Heart"},{"issue":"29","key":"1413_CR16","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","volume":"37","author":"MF Piepoli","year":"2016","unstructured":"Piepoli\u00a0MF, Hoes\u00a0AW, Agewall\u00a0S, Albus\u00a0C, et\u00a0al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart\u00a0J. 2016;37(29):2315\u201381.","journal-title":"Eur Heart J"},{"issue":"12","key":"1413_CR17","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.4244\/EIJV9I12A245","volume":"9","author":"R van Domburg","year":"2014","unstructured":"van Domburg\u00a0R, Hoeks\u00a0S, Kardys\u00a0I, et\u00a0al. Tools and techniques\u2014statistics: how many variables are allowed in the logistic and Cox regression models? EuroIntervention. 2014;9(12):1472\u20133.","journal-title":"EuroIntervention"},{"issue":"1","key":"1413_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","volume":"67","author":"L Anderson","year":"2016","unstructured":"Anderson\u00a0L, Oldridge\u00a0N, Thompson\u00a0DR, et al. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. J\u00a0Am Coll Cardiol. 2016;67(1):1\u201312.","journal-title":"J Am Coll Cardiol"},{"issue":"18","key":"1413_CR19","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1177\/2047487316671181","volume":"23","author":"B Rauch","year":"2016","unstructured":"Rauch\u00a0B, Davos\u00a0CH, Doherty\u00a0P, et al. The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: a systematic review and meta-analysis of randomized and non-randomized studies\u2014The Cardiac Rehabilitation Outcome Study (CROS). Eur J Prev Cardiol. 2016;23(18):1914\u201339.","journal-title":"Eur J Prev Cardiol"},{"issue":"11","key":"1413_CR20","doi-asserted-by":"publisher","first-page":"NP1","DOI":"10.1177\/2047487316653709","volume":"23","author":"MF Piepoli","year":"2016","unstructured":"Piepoli\u00a0MF, Hoes\u00a0AW, Agewall\u00a0S, et\u00a0al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol. 2016;23(11):NP1\u2013NP96.","journal-title":"Eur J Prev Cardiol"},{"issue":"6","key":"1413_CR21","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1177\/2047487315569401","volume":"23","author":"K Kotseva","year":"2016","unstructured":"Kotseva\u00a0K, Wood\u00a0D, De Bacquer\u00a0D, et\u00a0al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016;23(6):636\u201348.","journal-title":"Eur J Prev Cardiol"},{"issue":"3","key":"1413_CR22","first-page":"168","volume":"4","author":"M Sunamura","year":"2018","unstructured":"Sunamura\u00a0M, Ter Hoeve\u00a0N, van den Berg-Emons\u00a0RJ, et al. Cardiac rehabilitation in patients with acute coronary syndrome with primary percutaneous coronary intervention is associated with improved 10-year survival. Eur Heart J Qual Care Clin Outcomes. 2018;4(3):168\u201372.","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"issue":"4","key":"1413_CR23","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1097\/00008483-200307000-00005","volume":"23","author":"BK Sanderson","year":"2003","unstructured":"Sanderson\u00a0BK, Phillips\u00a0MM, Gerald\u00a0L, et\u00a0al. Factors associated with the failure of patients to complete cardiac rehabilitation for medical and nonmedical reasons. J\u00a0Cardiopulm Rehabil. 2003;23(4):281\u20139.","journal-title":"J Cardiopulm Rehabil"},{"key":"1413_CR24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.ypmed.2015.04.009","volume":"80","author":"DE Gaalema","year":"2015","unstructured":"Gaalema\u00a0DE, Cutler\u00a0AY, Higgins\u00a0ST, Ades\u00a0PA. Smoking and cardiac rehabilitation participation: associations with referral, attendance and adherence. Prev Med. 2015;80:67\u201374.","journal-title":"Prev Med"}],"container-title":["Netherlands Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12471-020-01413-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12471-020-01413-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12471-020-01413-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T00:15:56Z","timestamp":1616199356000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12471-020-01413-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["1413"],"URL":"https:\/\/doi.org\/10.1007\/s12471-020-01413-1","relation":{},"ISSN":["1568-5888","1876-6250"],"issn-type":[{"value":"1568-5888","type":"print"},{"value":"1876-6250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,20]]},"assertion":[{"value":"20 March 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.\u00a0Sunamura, N.\u00a0ter Hoeve, R.J.G.\u00a0van den Berg-Emons, E.\u00a0Boersma, M.L.\u00a0Geleijnse and R.T.\u00a0van Domburg declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}