TOPLINE

Structured telerehabilitation was as effective as traditional in-person cardiac rehabilitation after acute coronary syndrome (ACS), helping more than 80% of patients meet cardiovascular risk factor and lifestyle goals within 8 weeks. Both approaches produced similar gains in exercise capacity, programme adherence, and patient satisfaction through 6 months of follow-up.

METHODOLOGY

• Researchers conducted a randomised controlled trial (TELECOR) at a tertiary hospital in Spain to evaluate whether a structured telerehabilitation programme was non-inferior to conventional centre-based cardiac rehabilitation for helping patients recover after ACS and achieve guideline-recommended cardiovascular risk factor and lifestyle targets in routine clinical practice.
• The trial enrolled 129 patients (mean age, 57.6 years; 86.8% men) between October 2021 and January 2023 who experienced ACS within the previous 2 months. They were randomly assigned to either an 8-week structured telerehabilitation programme (n = 65) or standard centre-based cardiac rehabilitation programme (n = 64). Patients were followed up for 6 months.
• Patients in both groups completed 20 sessions over 8 weeks that included aerobic and strength training. Those in the telerehabilitation group exercised at home under remote video supervision and used a wrist-worn fitness tracker to monitor heart rate, whereas those in the centre-based group attended supervised hospital sessions in person.
• The primary endpoint was the proportion of patients meeting at least four of seven predefined cardiovascular risk factor and lifestyle targets (including blood pressure, low-density lipoprotein cholesterol, weight, smoking status, diet, and physical activity) at 8 weeks.
• Telerehabilitation was considered non-inferior if it achieved results similar to those of centre-based rehabilitation within a predefined 20% margin, assuming an 80% response rate in both groups.

TAKEAWAY

• At 8 weeks, 86.0% of patients in the telerehabilitation group and 79.7% of those in the centre-based group achieved the composite cardiovascular risk and lifestyle target, with no significant difference observed between the two groups (P = .37); similarly, at 6 months, the corresponding rates were 87.0% and 80.4%, respectively (P = .34).
• Blood pressure control, smoking abstinence, healthy diet adherence, and adequate physical activity were the most frequently achieved individual targets (> 80% in both groups), whereas waist circumference and weight goals were met by fewer than 60% of patients.
• Functional capacity rose from 6.81 to 7.67 metabolic equivalents of task (METs) in the telerehabilitation group (P = .02) and from 6.08 to 7.53 METs in the centre-based group (P < .0001), with no significant between-group difference at follow-up (P = .67).
• Patients in both groups maintained a high quality of life, but those in the telerehabilitation group reported greater improvements in overall health and well-being at 8 weeks (P = .034). Programme adherence remained high in both groups, satisfaction was high overall, and cardiac event rates were similar between the two groups through 6 months.

IN PRACTICE

"TELECOR shows that structured telerehabilitation can be implemented at scale in public health systems, achieving equivalent secondary prevention results to centre-based CR [cardiac rehabilitation]. These findings support the integration of structured telerehabilitation into routine secondary prevention programs," the researchers wrote.

SOURCE

The study was led by Maria Boldó Alcaine, University Hospital Germans Trias i Pujol, Barcelona, Spain. It was published online on September 24, 2026, in European Heart Journal Open.

LIMITATIONS

The reliance on patient-reported assessments of physical activity, diet, and satisfaction may have introduced reporting bias. The study was powered to assess non-inferiority in the primary outcome but may not have detected smaller differences in psychological outcomes or adverse events. The single-centre design may have limited the generalisability of the findings, despite the real-world clinical setting.

DISCLOSURES

The study received financial support from Laboratorios Ferrer, and Vitalera Health provided access to the telerehabilitation platform. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.