Prehabilitation in Patients Undergoing Cardiac Procedures
Year: 2026
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: Evidence supporting prehabilitation before cardiac procedures is growing, but the efficacy of different components remains unclear. OBJECTIVES: The primary aim was to assess the efficacy of prehabilitation on clinical outcomes based on recent randomized controlled trials (RCTs). The secondary aim was to identify effective intervention and which patient subgroups benefit most. METHODS: We searched Medline, Web of Science, PsycINFO, Embase, Scopus, and Cochrane Central Register of Controlled Trials Library for RCTs comparing prehabilitation with standard care in cardiac patients up to August 2024. Trials were screened by 2 reviewers and meta-analyses were performed using random-effects models. RESULTS: Forty-four RCTs including 3,925 patients were identified. Prehabilitation improved preprocedural functional capacity (6-minute walk distance) and recovery (in-hospital length of stay, intensive care unit stay, and occurrence of postprocedural pneumonia). Six trials (n = 600) showed improved 6-minute walk distance (mean difference [MD] 68.87 m; 95% CI: 12.76-124.98 m; P = 0.020). In 18 studies (n = 1,568), length of stay was shorter (MD -0.95 days; 95% CI: -1.77 to -0.13 days; P = 0.026) and meta-regression showed greater effect in studies including more women (P = 0.015). In 16 trials (n = 1,149), intensive care unit stay was reduced (MD -6.03 hours; 95% CI: -12.01 to -0.06 hours; P = 0.048). In 5 studies (n = 729), postprocedural pneumonia occurred less frequently (OR: 0.33; 95% CI: 0.15-0.72; P = 0.017). The analysis revealed substantial heterogeneity and risk of bias. Analysis of specific components showed no consistent effects. CONCLUSIONS: Prehabilitation before cardiac procedures may enhance preprocedural functional capacity and postprocedural recovery, particularly in women. Further multicenter studies are needed.
Source: JACC Advances
Authors: Carolin Steinmetz, Phuc Thien Tran, Stephanie Heinemann, Daniel Arroyo-Ariza, Jane Jurayj, Nicole B. Katz, Johanneke Hartog, Thomas Schmidt, Bart Scheenstra, Hermioni L. Amonoo, Elizabeth N. Madva, Jason Z. Qu, Oluwaseun Akeju, Jeffery C. Huffman, Ingo Kutschka, Christoph Herrmann-Lingen, Julie K. Silver, Christine A.F. von Arnim, Anna Lee, Christian Röver, Christopher M. Celano, Monika Sadlonova
Institutions: Universitätsmedizin Göttingen, University of Göttingen, UMIT TIROL - Private University for Health Sciences and Health Technology, Barnes-Jewish Hospital, Washington University in St. Louis, University of Rochester Medicine, University of Rochester, Harvard University, Spaulding Rehabilitation Hospital, University Medical Center Groningen, University of Groningen, German Sport University Cologne, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Dana-Farber Brigham Cancer Center, Massachusetts General Hospital, Mass General Brigham, German Centre for Cardiovascular Research, Wake Forest University Health Sciences, Wake Forest University, Chinese University of Hong Kong
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,936
Funders: Eli Lilly and Company, Roche, Biogen, Edwards Lifesciences, Stichting Beatrixoord Noord-Nederland, European Commission, Robert Bosch Stiftung, Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, Novo Nordisk, Deutsche Herzstiftung, Fundação Oswaldo Cruz, Niedersächsisches Ministerium für Wissenschaft und Kultur, Gemeinsame Bundesausschuss, National Institutes of Health, National Heart, Lung, and Blood Institute, National Cancer Institute, Dr. Willmar Schwabe
OpenAlex ID: W7126022805