{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:02:18Z","timestamp":1787580138260,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007312","name":"National Center for Geriatrics and Gerontology","doi-asserted-by":"publisher","award":["22\u20109"],"award-info":[{"award-number":["22\u20109"]}],"id":[{"id":"10.13039\/501100007312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n During the COVID\u201019 pandemic, some patients experienced difficulty attending regular in\u2010hospital cardiac rehabilitation (CR) after discharge. This study investigated the impact of CR in older patients with cardiovascular disease (CVD) by comparing outcomes before, during, and after the COVID\u201019 pandemic.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this post hoc analysis of a single\u2010center registry, 505 patients aged \u2265\u200965\u2009years (mean age 82) were included. Outcomes were compared between participants in a 4\u2010month outpatient CR program after discharge and non\u2010participants. Patients were categorized into three periods: before the COVID\u201019 pandemic (\n n<\/jats:italic>\n \u2009=\u2009173), during the COVID\u201019 pandemic (\n n<\/jats:italic>\n \u2009=\u2009217), and after the COVID\u201019 pandemic (\n n<\/jats:italic>\n \u2009=\u2009105). Cardiovascular (CV) events and non\u2010CV events were followed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n As the primary endpoint, cumulative hospitalization for worsening HF was significantly lower in the CR group across all time periods (\n p<\/jats:italic>\n \u2009<\u20090.001,\n p<\/jats:italic>\n \u2009<\u20090.001, and\n p<\/jats:italic>\n \u2009=\u20090.019, respectively). Cumulative non\u2010CV event\u2010free survival was significantly higher in the CR group before and after the COVID\u201019 pandemic (\n p<\/jats:italic>\n \u2009<\u20090.001,\n p<\/jats:italic>\n \u2009=\u20090.030, respectively) but showed no significant differences during the pandemic. Before the pandemic, participation in CR was significantly associated with hospitalization for worsening HF (hazard ratio [HR], 0.538; 95% confidence interval [CI], 0.294\u20130.982;\n p<\/jats:italic>\n \u2009=\u20090.043). During and after the pandemic, this association was not.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n CR appears to have a protective effect against CV events in older patients with CVD. Although the COVID\u201019 pandemic disrupted this positive trend, the findings support CR as a cornerstone of recovery in this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ggi.70395","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T10:56:14Z","timestamp":1770807374000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Impact of Cardiac Rehabilitation in Older Patients With Cardiovascular Disease: A Three\u2010Period Analysis Around the\n COVID<\/scp>\n \u201019 Pandemic"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1123-1782","authenticated-orcid":false,"given":"Akihiro","family":"Hirashiki","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kamihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Kokubo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-0711","authenticated-orcid":false,"given":"Kakeru","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikue","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Tanioku","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuya","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital National Center for Geriatrics and Gerontology Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-020-00164-9"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.030"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.22003"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-0695-z"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.122.009618"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.06.004"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-24-0266"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31713-5"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000031"},{"key":"e_1_2_13_12_1","first-page":"352","article-title":"Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure","volume":"23","author":"Bozkurt B.","year":"2021","journal-title":"Journal of Cardiac 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