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 and Objectives: We aimed to ascertain the predictive power of the left atrial coupling index (LACI) in patients with end stage renal disease (ESRD) for heart failure with preserved ejection fraction (HFpEF). Materials and Methods: This is a retrospective study including 100 subjects between 18 and 65 years of age with ESRD and not on dialysis treatment. Patients were divided into groups with and without HFpEF. The LACI was defined as the ratio of the left atrial volume index (LAVI) to the a′ wave in tissue Doppler imaging (TDI). Statistical analyses were performed, including univariate and multivariate regression analyses. Results: The mean age of the participants was 47 ± 13.3 years. Individuals with HFpEF exhibited a higher LACI. Univariate and multivariate regression analyses demonstrated that the predictive capacity of the LACI for HFpEF was considerably higher than that of the LAVI and other echocardiographic parameters. Conclusions: Higher LACI levels were consistently related to the presence of HFpEF in ESRD patients. The LACI can be easily obtained in daily practice using conventional Doppler echocardiographic measurements during left atrial functional assessments.

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.