A RECENT study found that multimodal, personalised teleprehabilitation significantly reduced major adverse cardiovascular events (MACE) in patients undergoing elective cardiac surgery. This randomised controlled trial aimed to assess the effectiveness of a structured, remote prehabilitation program on clinical cardiovascular outcomes for patients awaiting cardiac surgery or other related procedures, many of whom had modifiable risk factors that could impact perioperative outcomes. Previous studies have shown prehabilitation can improve patients’ physical and mental readiness; however, its specific influence on cardiovascular events post-surgery remained unstudied, motivating this investigation.
The study enrolled 394 patients scheduled for elective cardiac surgery or transcatheter procedures across multiple centres. Patients were randomised into two groups: 197 received a personalised teleprehabilitation program designed by a multidisciplinary team, while 197 served as controls receiving standard care. The primary outcome measure was the occurrence of MACE within one year postoperatively, including cardiovascular death, myocardial infarction, stroke, heart failure hospitalization, and the need for additional interventions. Secondary outcomes included hospital length of stay, quality of life, postoperative complications, and adherence to risk-reducing activities like smoking cessation. Events were reviewed by a blinded adjudication committee, and sensitivity analyses were conducted to ensure the consistency of findings. Results showed a MACE occurrence of 16.8% in the teleprehabilitation group compared to 25.5% in the control group, a statistically significant 8.8% reduction (95% CI 0.7 to 16.8; P=0.032). This reduction was most notable in patients undergoing surgery, with an adjusted odds ratio of 0.54 (95% CI, 0.30–0.96; P=0.035).
These findings suggest that teleprehabilitation can be an effective intervention to lower cardiovascular risk in elective cardiac surgery, showing potential for integration into clinical practice to improve patient outcomes. The reduction in risk factors like smoking and pulmonary risk further highlights the potential of remote, patient-centred programs in preoperative care. While further research could explore optimal duration and components of prehabilitation, teleprehabilitation represents a promising approach to enhance preoperative risk management, reduce adverse events, and support recovery in elective cardiac surgery.
Reference
Scheenstra B et al. The effect of teleprehabilitation on adverse events after elective cardiac surgery: a randomized controlled trial. J Am Coll Cardiol. 2024;DOI:10.1016/j.jacc.2024.10.064.
