Telerehabilitation vs Centre-Based Cardiac Rehabilitation After Acute Coronary Syndrome: Results of the Pragmatic TELECOR Randomised Trial
Maria Boldó Alcaine, M J Durà Mata, Gabriel-Fernando Sandoval Ruíz, Maria Llaberia Marcual, Marta Carceller de la Torre, Mar Domingo Teixidor, Evelyn Santiago Vacas, Antoni Bayés GenísAbstract
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 randomised controlled trial study aims to evaluate the effectiveness of a structured telerehabilitation program compared with standard centre-based CR in patients after ACS, focusing on cardiovascular risk factor control and lifestyle adherence.
Methods
TELECOR is a pragmatic, open-label, randomised trial conducted at a tertiary public hospital. Adults with recent ACS were randomised 1:1 to an 8-week structured telerehabilitation or centre-based CR program. 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.
Results
A total of 129 patients were randomised (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 MET), 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.