{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:55:52Z","timestamp":1790297752277,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,2,19]]},"abstract":"\n Background<\/jats:title>\n \n Despite the epidemic of cardiovascular diseases in middle\u2010income countries, few trials are testing the benefits of cardiac rehabilitation (\n CR<\/jats:styled-content>\n ). This trial assessed (1) maintenance of functional capacity, risk factor control, knowledge, and heart\u2010health behaviors and (2) mortality and morbidity at 6\u00a0months following\n CR<\/jats:styled-content>\n in a middle\u2010income country.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Eligible Brazilian coronary patients were initially randomized (1:1:1 concealed) to 1 of 3 parallel arms (comprehensive\n CR<\/jats:styled-content>\n [exercise plus education], exercise\u2010only\n CR<\/jats:styled-content>\n , or wait\u2010list control). The\n CR<\/jats:styled-content>\n programs were 6\u00a0months in duration, at which point follow\u2010up assessments were performed. Mortality and morbidity were ascertained from chart and patient or family report (blinded). Controls were then offered\n CR<\/jats:styled-content>\n (crossover). Outcomes were again assessed 6\u00a0months later (blinded). ANCOVA was performed for each outcome at 12\u00a0months. Overall, 115 (88.5%) patients were randomized, and 62 (53.9%) were retained at 1\u00a0year. At 6\u00a0months, 23 (58.9%) of those 39 initially randomized to the wait\u2010list control elected to attend\n CR<\/jats:styled-content>\n . Functional capacity, risk factors, knowledge, and heart\u2010health behaviors were maintained from 6 to 12\u00a0months in participants from both\n CR<\/jats:styled-content>\n arms (all\n P<\/jats:italic>\n >0.05). At 1\u00a0year, knowledge was significantly greater with comprehensive\n CR<\/jats:styled-content>\n at either time point (\n P<\/jats:italic>\n <0.001). There were 2 deaths. Hospitalizations (\n P<\/jats:italic>\n =0.03), nonfatal myocardial infarctions (\n P<\/jats:italic>\n =0.04), and percutaneous coronary interventions (\n P<\/jats:italic>\n =0.03) were significantly fewer with\n CR<\/jats:styled-content>\n than control at 6 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CR<\/jats:styled-content>\n participation is associated with lower morbidity, long\u2010term maintenance of functional capacity, risk factors, and heart\u2010health behaviors, as well as with greater cardiovascular knowledge compared with no\n CR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 02575976.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011228","type":"journal-article","created":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T05:02:06Z","timestamp":1550206926000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Maintenance of Gains, Morbidity, and Mortality at 1 Year Following Cardiac Rehabilitation in a Middle\u2010Income Country: A Wait\u2010List Control Crossover Trial"],"prefix":"10.1161","volume":"8","author":[{"given":"Gabriela S. S.","family":"Chaves","sequence":"first","affiliation":[{"name":"Physical Therapy Department Federal University of Minas Gerais Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Lima de Melo Ghisi","sequence":"additional","affiliation":[{"name":"Cardiovascular Prevention and Rehabilitation Program Toronto Rehabilitation Institute University Health Network University of Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel R.","family":"Britto","sequence":"additional","affiliation":[{"name":"Physical Therapy Department Federal University of Minas Gerais Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry L.","family":"Grace","sequence":"additional","affiliation":[{"name":"Cardiovascular Prevention and Rehabilitation Program Toronto Rehabilitation Institute University Health Network University of Toronto Canada"},{"name":"School of Kinesiology and Health Science York University Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","volume-title":"Global Status Report on Noncommunicable Diseases","author":"World Health Organization","year":"2014","unstructured":"World Health Organization . Global Status Report on Noncommunicable Diseases. Geneva: WHO; 2014. Available at: http:\/\/www.who.int\/nmh\/publications\/ncd-status-report-2014\/en\/. Accessed October 07, 2018."},{"key":"e_1_3_2_3_2","unstructured":"Brasil Minist\u00e9rio da Sa\u00fade . Sistema de Informa\u00e7\u00f5es de Mortalidade SIM e IBGM. 2014. Available at: http:\/\/tabnet.datasus.gov.br\/CGI\/idb2006\/matriz.htm. Accessed October 06 2018."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-309209"},{"key":"e_1_3_2_5_2","volume-title":"The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017","author":"British Association for Cardiovascular Prevention and Rehabilitation","year":"2017","unstructured":"British Association for Cardiovascular Prevention and Rehabilitation . The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017. 3rd ed. London: British Cardiovascular Society; 2017. 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Int J Behav Nutr Phys Act. 2011;8:1\u201319.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2016.09.004"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCN.0b013e31829c1414"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1658-1"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.011228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:50:49Z","timestamp":1715586649000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.011228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,19]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,2,19]]}},"alternative-id":["10.1161\/JAHA.118.011228"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.011228","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,19]]},"assertion":[{"value":"2018-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011228"}}