European heart journal open · 2026
Telerehabilitation vs. centre-based cardiac rehabilitation after acute coronary syndrome: results of the pragmatic TELECOR randomized trial.
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Boldó Alcaine Maria, Durà Mata Maria José, Sandoval Ruíz Gabriel-Fernando, Llaberia Marcual Maria, Carceller de la Torre Marta, Domingo Teixidor Mar, Santiago Vacas Evelyn, Bayés Genís Antoni
Аннотация
AIMS: Cardiac rehabilitation (CR) improves cardiovascular outcomes after acute coronary syndrome (ACS), but access remains suboptimal. Telerehabilitation may overcome barriers, yet evidence from real-world, public health systems is limited. This randomized controlled trial study aimed to evaluate the effectiveness of a structured telerehabilitation programme compared with standard centre-based CR in patients after ACS, focussing on cardiovascular risk factor control and lifestyle adherence.
METHODS AND RESULTS: TELECOR is a pragmatic, open-label, randomized trial conducted at a tertiary public hospital. Adults with recent ACS were randomized 1:1 to an 8 week structured telerehabilitation or a centre-based CR programme. The primary outcome was achievement of a composite target (≥4 of 7 predefined cardiovascular and lifestyle goals) at 8 weeks. Secondary outcomes included changes in functional capacity, medication adherence, quality of life, psychological status, satisfaction, and cardiovascular events at 6 months. A total of 129 patients were randomized (65 telerehabilitation, 64 centre-based). At 8 weeks, 86% of telerehabilitation vs. 79.7% of centre-based participants met the composite target (P = 0.37). At 6 months, this was 87% vs. 80.4% (P = 0.34). Both groups showed similar improvements in functional capacity (≈+1 metabolic equivalent of tasks), adherence (>84%), and satisfaction (>91/100). No between-group differences were observed in clinical events or psychological outcomes.
CONCLUSION: In a real-world public hospital setting, telerehabilitation was non-inferior to conventional CR in achieving cardiovascular risk factor control and improving functional capacity. These results support the broader integration of digital CR models into routine secondary prevention care.
METHODS AND RESULTS: TELECOR is a pragmatic, open-label, randomized trial conducted at a tertiary public hospital. Adults with recent ACS were randomized 1:1 to an 8 week structured telerehabilitation or a centre-based CR programme. The primary outcome was achievement of a composite target (≥4 of 7 predefined cardiovascular and lifestyle goals) at 8 weeks. Secondary outcomes included changes in functional capacity, medication adherence, quality of life, psychological status, satisfaction, and cardiovascular events at 6 months. A total of 129 patients were randomized (65 telerehabilitation, 64 centre-based). At 8 weeks, 86% of telerehabilitation vs. 79.7% of centre-based participants met the composite target (P = 0.37). At 6 months, this was 87% vs. 80.4% (P = 0.34). Both groups showed similar improvements in functional capacity (≈+1 metabolic equivalent of tasks), adherence (>84%), and satisfaction (>91/100). No between-group differences were observed in clinical events or psychological outcomes.
CONCLUSION: In a real-world public hospital setting, telerehabilitation was non-inferior to conventional CR in achieving cardiovascular risk factor control and improving functional capacity. These results support the broader integration of digital CR models into routine secondary prevention care.