Cardiac Rehabilitation for Coronary Artery Disease: Gaps, Digital Models, and the Future of Personalized Prevention.

Cardiovascular disease is the leading cause of global morbidity and mortality, with coronary artery disease representing the primary driver of premature death. Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that integrates exercise, risk factor modification, and education. CR reduces all-cause mortality, recurrent ischemic events, and improves quality of life. Yet, participation remains suboptimal, and CR is underutilized by women, older adults, minorities, and socioeconomically disadvantaged groups. We examine the modalities of CR including traditional center-based CR (CBCR), home-based CR and hybrid models. By leveraging telemedicine, mobile health, and wearable biosensors remote delivery of CR has shown comparable efficacy to traditional CBCR. The integration of artificial intelligence offers opportunities to personalize CR through continuous physiological monitoring and exercise prescriptions. In conclusion, CR remains cost-effective from a health-system perspective, but patient-level affordability and equitable access require targeted policy, financial, and culturally adapted interventions to ensure personalized and equitable delivery of secondary prevention.