# Analysis of a Real-World Population Participating in a Cardiac Rehabilitation Program: Cognitive Impairment, Functional Capacity, and Therapy Titration

## TL;DR

This study analyzed patients in a cardiac rehabilitation program, finding improved physical function and increased use of a specific drug therapy after rehabilitation.

## Contribution

The study provides new insights into the effectiveness of cardiac rehabilitation in patients with cognitive impairment and highlights changes in drug therapy usage.

## Key findings

- Patients showed significant improvement in the 6-minute walk test after cardiac rehabilitation.
- 22% of patients had cognitive impairment as indicated by the Qmci score.
- There was a significant increase in the use of SGLT2i therapy after rehabilitation.

## Abstract

Background: Cardiac rehabilitation (CR) is a fundamental pillar in the therapeutic pathway of patients with cardiovascular disease, contributing significantly to improving quality of life and reducing the risk of cardiovascular event recurrence. Over the past decades, this approach has progressively evolved, integrating multidisciplinary strategies based on scientific evidence. This study aimed to conduct a detailed analysis of the anthropometric, clinical, and functional characteristics of patients enrolled in the CR Unit of the San Giovanni di Dio and Ruggi D’Aragona University Hospital in Salerno, with particular attention to therapeutic changes, drug titration, and cognitive assessment. Methods: Specifically, the anthropometric, clinical, laboratory, and instrumental data of 95 patients (age 66.56 ± 0.99 years, 75% male) who underwent the CR program between 2023 and 2025 were analyzed. Results: Patients with various diagnoses were enrolled in the CR program: 17% heart failure, 18% cardiac surgery, 20% acute coronary syndrome, 16% chronic coronary syndrome, 29% dyspnea. The patients had numerous comorbidities and risk factors: 73% arterial hypertension, 77% dyslipidemia, 35% diabetes mellitus, 33% smoking, 13% thyroid dysfunction, 47% CAD, 18% CKD, 16% COPD. At baseline, Cardiopulmonary exercise test (CPET) showed a moderately reduced functional capacity (VO2 peak pre-CR: 14.29 ± 0.53 mL/min/kg; VO2% predicted pre-CR: 62.19 ± 2.43%), and a significant improvement was recorded in meters at 6 min walk test (6MWT) post-CR (pre-CR: 306.02 ± 9.93 m vs. post-CR: 378.88 ± 13.37 m; p < 0.05). Notably, 22% of patients had a Qmci score < 49.4 points, indicating an MCI. Finally, the cardiovascular therapy was titrated and adapted; specifically, we recorded a significant increase in the use of SGLT2i therapy (pre-RC 22.00% vs. post-RC 34.00%; p < 0.05). Conclusions: In conclusion, CR proved to be safe and effective in enrolled patients; further studies will be needed to investigate the therapeutic modifications implemented during CR programs in more detail.