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KMID : 1164620190520040248
Korean Journal of Thoracic and Cardiovascular Surgery
2019 Volume.52 No. 4 p.248 ~ p.329
Clinical Practice Guideline for Cardiac Rehabilitation in Korea
Kim Chul

Sung Ji-Dong
Lee Jong-Hwa
Kim Won-Seok
Lee Goo-Joo
Jee Sung-Ju
Jung Il-Young
Rah Ueon-Woo
Kim Byung-Ok
Choi Kyoung-Hyo
Kwon Bum-Sun
Yoo Seung-Don
Bang Heui-Je
Shin Hyung-Ik
Kim Yong-Wook
Jung Hee-Youne
Kim Eung-Ju
Lee Jung-Hwan
Jung In-Hyun
Jung Jae-Seung
Lee Jong-Young
Han Jae-Young
Han Eun-Young
Won Yu-Hui
Han Woo-Sik
Baek So-Ra
Joa Kyung-Lim
Lee Sook-Joung
Kim Ae-Ryoung
Lee So-Young
Kim Ji-Hee
Choi Hee-Eun
Lee Byeong-Ju
Kim Soon
Abstract
Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea.

Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors?primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified.

Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR.

Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
KEYWORD
Acute coronary syndrome, Cardiac rehabilitation, Mortality, Clinical practice guidelines, Secondary prevention
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