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Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome

Korean Circulation Journal 2019년 49권 11호 p.1066 ~ 1111
 ( Kim Chul ) - Inje University College of Medicine Sanggye Paik Hospital Department of Rehabilitation Medicine

 ( Sung Ji-Dong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
 ( Lee Jong-Hwa ) - Dong-A University College of Medicine Dong-A Medical Center Department of Physical Medicine and Rehabilitation
 ( Kim Won-Seok ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Rehabilitation Medicine
 ( Lee Goo-Joo ) - Chungbuk National University College of Medicine Chungbuk National University Hospital Department of Rehabilitation Medicine
 ( Jee Sung-Ju ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Rehabilitation Medicine
 ( Jung Il-Young ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Rehabilitation Medicine
 ( Rah Ueon-Woo ) - Ajou University School of Medicine Department of Physical Medicine and Rehabilitation
 ( Kim Byung-Ok ) - Inje University College of Medicine Sanggye Paik Hospital Department of Internal Medicine
 ( Choi Kyoung-Hyo ) - University of Ulsan College of Medicine Asan Medical Center Department of Rehabilitation Medicine
 ( Kwon Bum-Sun ) - Dongguk University School of Medicine Department of Rehabilitation Medicine
유승돈 ( Yoo Seung-Don ) - Kyung Hee University College of Medicine Department of Rehabilitation Medicine
 ( Bang Heui-Je ) - Chungbuk National University College of Medicine Chungbuk National University Hospital Department of Rehabilitation Medicine
 ( Shin Hyung-Ik ) - Seoul National University College of Medicine Seoul National University Children’s Hospital Department of Rehabilitation Medicine
 ( Kim Yong-Wook ) - Yonsei University College of Medicine Department of Rehabilitation Medicine
 ( Jung Hee-Youne ) - National Traffic Injury Rehabilitation Hospital
 ( Kim Eung-Ju ) - Korea University College of Medicine Korea University Guro Hospital Department of Internal Medicine
 ( Lee Jung-Hwan ) - Namdarun Rehabilitation Clinic
 ( Jung In-Hyun ) - Inje University College of Medicine Sanggye Paik Hospital Department of Internal Medicine
 ( Jung Jae-Seung ) - Korea University Anam Hospital Department of Thoracic and Cardiovascular Surgery
 ( Lee Jong-Young ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
 ( Han Jae-Young ) - Chonnam National University Medical School Chonnam National University Hospital Department of Rehabilitation Medicine
 ( Han Eun-Young ) - Jeju National University School of Medicine Jeju National University Hospital Department of Rehabilitation Medicine
 ( Won Yu-Hui ) - Chonbuk National University Hospital Department of Physical Medicine and Rehabilitation
 ( Han Woo-Sik ) - Chungnam National University Hospital Department of Thoracic Surgery
 ( Baek So-Ra ) - Kangwon National University School of Medicine Kangwon National University Hospital Department of Rehabilitation Medicine
 ( Joa Kyung-Lim ) - Inha University Hospital Department of Rehabilitation Medicine
 ( Lee Sook-Joung ) - Catholic University College of Medicine Daejeon St. Mary’s Hospital Department of Physical Medicine and Rehabilitation
 ( Kim Ae-Ryoung ) - Kyungpook National University School of Medicine Department of Rehabilitation Medicine
 ( Lee So-Young ) - Jeju National University School of Medicine Jeju National University Hospital Department of Rehabilitation Medicine
 ( Kim Ji-Hee ) - Wonkwang University School of Medicine Department of Rehabilitation Medicine
 ( Choi Hee-Eun ) - Inje University College of Medicine Inje University Haeundae Paik Hospital Department of Physical Medicine and Rehabilitation
 ( Lee Byeong-Ju ) - Pusan National University Hospital Department of Rehabilitation Medicine
 ( Kim Soon ) - Ewha Womans University Research Institute for Social Science

Abstract


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

키워드

Acute coronary syndrome; Cardiac rehabilitation; Mortality; Clinical practice guideline; Secondary prevention
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