OPTImal CArdiac REhabilitation (OPTICARE) following Acute Coronary Syndromes: Rationale and design of a randomised, controlled trial to investigate the benefits of expanded educational and behavioural intervention programs

Abstract

The majority of cardiac rehabilitation (CR) referrals consist of patients who have survived an acute coronary syndrome (ACS). Although major changes have been implemented in ACS treatment since the 1980s, which highly influenced mortality and morbidity, CR programs have barely changed and only few data are available on the optimal CR format in these patients. We postulated that standard CR programs followed by relatively brief maintenance programs and booster sessions, including behavioural techniques and focusing on incorporating lifestyle changes into daily life, can improve long-term adherence to lifestyle modifications. These strategies might result in improved (cardiac) mortality and morbidity in a cost-effective fashion. In the OPTImal CArdiac REhabilitation (OPTICARE) trial we will assess the effects of two advanced and extended CR programs that are designed to stimulate permanent adaption of a heart-healthy lifestyle, compared with current standard CR, in ACS patients. We will study the effects in terms of cardiac risk profile, levels of daily physical activity, quality of life and health care consumption.

Exercise-based cardiac rehabilitation in patients with coronary heart disease: a practice guideline

“…Also research is needed on strategies to improve monitoring and follow-up of the maintenance of a physical active lifestyle after supervised CR; for example by implementing activity monitoring devices combined with telemonitoring, or by web-based coaching platforms to guide patients [10]. Finally, more research is needed into characteristics and modalities of physical activity and exercise training in cardiovascular risk management in the long term [42]. …”

Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes

“…The OPTICARE trial was an open, randomised controlled superiority trial; the full study design has been published previously 8. The trial, which was registered at ClinicalTrials.gov (NCT01395095), used the PROBE (PRospective Open, Blinded Endpoint) design 9.…”

Patients who do not complete cardiac rehabilitation have an increased risk of cardiovascular events during long-term follow-up

“…Recently, we presented the OPTImal CArdiac REhabilitation (OPTICARE) trial; a randomised controlled CR trial that enrolled 914 patients post acute coronary syndrome (ACS) [14,15]. All patients started a 'standard' 12-week CR programme, and we aimed to assess an association between completion of the programme and incidence of adverse cardiac events during prolonged follow-up.…”