Background: Acute coronary syndrome (ACS) remains a major contributor to cardiovascular morbidity and mortality. Cardiac rehabilitation programs have shown promise in improving adherence to lifestyle and medical recommendations, yet their impact on clinical outcomes and complications requires further investigation. Methods: This prospective, randomized, single‐center study evaluated the effects of cardiac rehabilitation on adherence and clinical outcomes in ACS patients. A total of 340 patients were randomized into a Cardiac Rehabilitation Group or Control Group. The Cardiac Rehabilitation Group underwent supervised exercise, dietary counseling, and education, while the Control Group received standard recommendations. Outcomes, including adherence rates and complications, were assessed over 1 year, with additional interim analyses to evaluate early sustainability of behavioral changes. Results: Patients in the Cardiac Rehabilitation Group demonstrated significant improvements in adherence to dietary recommendations (73.5% vs. 52.4%, p < 0.01) and physical activity (85.3% vs. 68.2%, p < 0.01). Cardiac Rehabilitation Group patients also experienced fewer instances of weight gain (22.9% vs. 34.7%, p = 0.017) and access site complications (21.2% vs. 40%, p < 0.01). Hospital readmissions were reduced in the Cardiac Rehabilitation Group compared to the Control Group (18.8% vs. 31.2%, p = 0.015). Non‐adherence to dietary recommendations (HR: 2.42, 95% CI: 1.08–5.41, p = 0.032) and medical treatments (HR: 2.84, 95% CI: 1.32–6.11, p = 0.007) were significantly associated with increased risk of revascularization. Conclusion: Cardiac rehabilitation significantly enhances adherence to medical and lifestyle recommendations, reduces complications, and improves outcomes in ACS patients. These findings emphasize the critical role of structured rehabilitation in post‐ACS management.

Background: Haloperidol and dexmedetomidine are used to treat delirium in the intensive care unit (ICU). The effects of these drugs on the corrected QT (QTc) interval have not been compared before. It was aimed to compare the effects of haloperidol and dexmedetomidine treatment on QTc intervals in patients who developed delirium during ICU follow-up. Method: The study is single-center, randomized, and prospective. Half of the patients diagnosed with delirium in the ICU were treated with haloperidol and the other half with dexmedetomidine. The QTc interval was measured in the treatment groups before and after drug treatment. The study’s primary endpoints were maximal QT and QTc interval changes after drug administration. Results: 90 patients were included in the study, the mean age was 75.2±12.9 years, and half were women. The mean time to delirium was 142+173.8 hours, and 53.3% of the patients died during their ICU follow-up. The most common reason for hospitalization in the ICU was sepsis (%37.8.). There was no significant change in QT and QTc interval after dexmedetomidine treatment (QT: 360.5±81.7, 352.0±67.0, p= 0.491; QTc: 409.4±63.1, 409.8±49.7, p=0.974). There was a significant increase in both QT and QTc interval after haloperidol treatment (QT: 363.2±51.1, 384.6±59.2, p=0.028; QTc: 409.4±50.9, 427.3±45.9, p=0.020). Conclusions: Based on the results obtained from the study, it can be concluded that the administration of haloperidol was associated with a significant increase in QT and QTc interval. In contrast, the administration of dexmedetomidine did not cause a significant change in QT and QTc interval.

Background: Coronary artery disease (CAD) and diabetes mellitus (DM) significantly increase the risk after acute coronary syndrome. This study evaluated adherence to guideline‐directed secondary prevention strategies and demonstrated their substantial impact on reducing rehospitalization and mortality in this population. Methods: A retrospective cohort study was conducted on 987 CAD and DM patients admitted for ACS between 2015 and 2018. Adherence to seven evidence‐based secondary prevention strategies was assessed: smoking cessation, physical activity, antiplatelet therapy, statins, blood pressure control, ACEi/ARB therapy, and SGLT‐2i therapy. Patients were categorized into groups based on the number of recommendations followed (0–2, 3–4, and 5+). Primary outcomes included rehospitalization and all‐cause mortality over a 3‐year follow‐up period. Results: At baseline, only 12.4% of patients adhered to five or more recommendations, which dramatically increased to 71.9% by the 3‐year follow‐up. Individual adherence to each of blood pressure control (HR = 0.81, 95% CI: 0.70–0.94), ACEi/ARB therapy (HR = 0.77, 95% CI: 0.67–0.89), and SGLT‐2i therapy (HR = 0.79, 95% CI: 0.68–0.92) significantly reduced rehospitalization risk. Similarly, adherence to these therapies individually reduced mortality risk (HR = 0.78, 95% CI: 0.67–0.91; HR = 0.74, 95% CI: 0.63–0.87; and HR = 0.72, 95% CI: 0.61–0.85, respectively). Importantly, a stepwise increase in adherence was associated with a dose‐dependent reduction in mortality (HR = 0.65, 95% CI: 0.52–0.81, p < 0.05). Conclusion: This study highlights the critical role of comprehensive, multifactorial secondary prevention in its association with improved long‐term outcomes in patients with CAD and DM following ACS.

Acute coronary syndrome (ACS) patients with multiple cardiovascular risk factors face particularly high recurrence rates. The differential impact of cardiac rehabilitation across ACS subtypes in high-risk patients remains understudied. This prospective, randomised, single-center study evaluated cardiac rehabilitation effects on adherence across ACS subtypes in high-risk patients. 260 patients with baseline smoking, BMI ≥25 kg/m², and physical inactivity were randomised 1:1 to cardiac rehabilitation or control groups. Patients were stratified by ACS type: STEMI, NSTEMI, and unstable angina pectoris (UAP). Primary outcomes included adherence to medical treatment, dietary recommendations, physical activity guidelines, smoking cessation, and weight management at one-year follow-up. Among 260 patients (130 rehabilitation, 130 control), NSTEMI was most common (45.4%), followed by STEMI (32.7%) and UAP (21.9%). Cardiac rehabilitation significantly improved adherence across all ACS subtypes. Overall adherence rates in rehabilitation vs. control groups were: medical treatment (89.2% vs. 71.5%, p < 0.001), dietary recommendations (82.3% vs. 58.5%, p < 0.001), physical activity (85.4% vs. 42.3%, p < 0.001), smoking cessation (76.9% vs. 43.1%, p < 0.001), and weight management (73.1% vs. 51.5%, p < 0.001). STEMI patients excelled in smoking cessation (84.7% vs. 38.6%), NSTEMI in physical activity (88.1% vs. 40.7%), and UAP in medical adherence (92.9% vs. 75.0%). All-cause rehospitalization rates were significantly lower in the rehabilitation group (12.3% vs. 23.1%, p = 0.023), as were cardiovascular-related rehospitalizations (7.7% vs. 18.5%, p = 0.012). Structured cardiac rehabilitation significantly enhances adherence to all secondary prevention measures across STEMI, NSTEMI, and UAP subtypes in high-risk patients, with subtype-specific patterns of improvement.