Assessment of Disease-Specific Guideline-Recommended Medical Therapy in Patients Admitted for Cardiac Rehabilitation After Cardiac Surgery

Objectives:

Guideline-recommended medical therapy (GRMT) is associated with improved clinical outcomes even after cardiac surgery. However, the extent to which GRMT is achieved at admission for postoperative cardiac rehabilitation remains insufficiently investigated. This study aimed to clarify the real-world status of disease-specific GRMT in this setting.

Materials and Methods:

We conducted a single-center, retrospective observational study including 44 consecutive patients admitted to our hospital for postoperative cardiac rehabilitation between March 1, 2025, and March 1, 2026. Patients who had undergone coronary artery bypass grafting (CABG) or valvular surgery were eligible. Medication profiles at admission were reviewed, and implementation rates of guideline-recommended drugs were evaluated according to clinical phenotype, including HFrEF, HFmrEF, HFpEF, and post-CABG secondary prevention.

Results:

The median age was 75 years; 25 patients (57%) were male, and the median Short Physical Performance Battery score was 10. Among the 44 patients, 21 underwent CABG and 25 valvular surgery. In patients with HFrEF, implementation rates of Class I–recommended agents—angiotensin receptor–neprilysin inhibitors, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, mineralocorticoid receptor antagonists, and sodium–glucose cotransporter 2 (SGLT2) inhibitors—were 71%, 86%, 57%, and 57%, respectively. In patients with HFmrEF/HFpEF, SGLT2 inhibitor use was 50%. Among patients after CABG, antithrombotic therapy was prescribed in 100%, lipid-lowering therapy in 81%, while achievement of the LDL-C target was observed in 24%.

Conclusion:

Achievement of disease-specific GRMT in patients admitted for postoperative cardiac rehabilitation was suboptimal. Hospitalization for cardiac rehabilitation may provide an important opportunity for multidisciplinary medication optimization.