Part 2-Cardiac Rehabilitation After an Acute Myocardial Infarction: Timing and Gender Differences in Adherence; Where Do We Stand?

Cardiac rehabilitation is a beneficial multidisciplinary interventional protocol that improves cardiovascular health and reduces mortality and morbidity rates in patients with cardiovascular diseases. Multiple studies have demonstrated that the implementation of such protocols in patients with acute myocardial infarction (MI) dramatically improved patients' outcome. It is unfortunate that in practice, in spite of the advantages of cardiac rehabilitation, this approach is seldom employed. Indeed, only some guidance, such as American College of Cardiology and European Society of Cardiology guidelines, recommends cardiac rehabilitation in their protocols. In particular, the European guideline recommends its early implementation while the patient is still in hospital, whereas the American guideline suggests that it should be approximately three weeks after discharge. In Part 1 of this two-part comprehensive review, we provided a historical overview of cardiac rehabilitation, a detailed examination of each component of the cardiac rehabilitation programme, and its impact on cardiovascular health. In Part 2, the objective was to provide a comprehensive explanation of the optimal timing for the commencement of the cardiac rehabilitation programme, and to elucidate the factors that influence low engagement in such programmes, as well as the gender-based differences in adherence.