The activities of daily living (ADL) in patients with cardiac disease tend to decline. A previous study revealed that ADL relates to physical and cognitive functions associated with health literacy (HL). However, the relationship between HL and ADL is not well documented. This study aimed to clarify this relationship among patients participating in cardiac rehabilitation. This multicenter study, the Kobe-Cardiac Rehabilitation project for people around the World (K-CREW), included patients who participated in cardiac rehabilitation from October 2020 to December 2021. Patients with probable dementia and difficulty walking alone were excluded. We used the 14-item Health Literacy Scale (HLS-14) to assess HL and the Functional Independence Measure (FIM) to assess ADL at discharge. Patients were divided by their HLS-14 score into the low HL group (<50 points) or the high HL group (≥50 points). We analyzed the relationship between the HLS-14 and FIM scores. We investigated 268 cardiac rehabilitation patients (median age, 71.0 years; male ratio, 76.9%). Low HL patients accounted for 51.1% of all patients and had significantly lower motor and cognitive FIM scores. Functional HL related better to the FIM scores (r = 0.28–0.36) than did other HL subclasses. Multiple regression analysis identified HLS-14 as an explanatory variable (p = 0.002) for the total FIM score. Patients with low HL had significantly lower ADL than those with high HL. These findings underscore the importance of considering HL in cardiac rehabilitation.

Chronic-phase worsening renal function (WRF) in patients with acute myocardial infarction (AMI) has been associated with poor prognosis. However, there is no consensus on either the method of prevention or the cause. The aim of this study was to determine factors predictive of chronic-phase WRF from the viewpoint of circulatory dynamics response to exercise during hospitalization of AMI patients without renal dysfunction on admission. We studied 186 consecutively AMI patients who underwent the 200-m walk test. Chronic-phase WRF was defined as a 20% decrease in estimated glomerular filtration rate (eGFR) from baseline to 8–10 months after AMI onset. Heart rate (HR) and systolic blood pressure recorded during the 200-m walk test were evaluated as circulatory dynamics responses. In total, 94 patients were enrolled. Multiple linear regression analysis showed that ΔHR (peak-rest) associated significantly with ΔeGFR (β = 0.427, p = 0.018). The receiver operating characteristic curve of ΔHR to predict chronic-phase WRF showed an area under the curve of 0.77, with a cut-off value of 22.0 bpm having a 95% sensitivity and 55% specificity. Among circulatory dynamics responses during exercise in the acute phase after AMI, ΔHR was an independent predictor of chronic-phase WRF.