All Publications
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Cardiac Rehabilitation for Coronary Artery Disease: Gaps, Digital Models, and the Future of Personalized Prevention.
The American journal of cardiology
2025
Abstract
Cardiovascular disease is the leading cause of global morbidity and mortality, with coronary artery disease representing the primary driver of premature death. Cardiac rehabilitation (CR) is a cornerstone of secondary prevention that integrates exercise, risk factor modification, and education. CR reduces all-cause mortality, recurrent ischemic events, and improves quality of life. Yet, participation remains suboptimal, and CR is underutilized by women, older adults, minorities, and socioeconomically disadvantaged groups. We examine the modalities of CR including traditional center-based CR (CBCR), home-based CR and hybrid models. By leveraging telemedicine, mobile health, and wearable biosensors remote delivery of CR has shown comparable efficacy to traditional CBCR. The integration of artificial intelligence offers opportunities to personalize CR through continuous physiological monitoring and exercise prescriptions. In conclusion, CR remains cost-effective from a health-system perspective, but patient-level affordability and equitable access require targeted policy, financial, and culturally adapted interventions to ensure personalized and equitable delivery of secondary prevention.
View details for DOI 10.1016/j.amjcard.2025.12.013
View details for PubMedID 41468986
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Comparison of International Expert Working Group Algorithms for Diagnosing Angina With Nonobstructive Coronary Arteries.
JACC. Cardiovascular interventions
2025; 18 (24): 2995-3005
Abstract
Coronary function testing (CFT) protocols in patients with angina with nonobstructive coronary arteries (ANOCA) differ among expert working groups. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorses testing for coronary artery spasm and microvascular dysfunction, while the Microvascular Network (MVN) recommends additional assessment for myocardial bridging and endothelial dysfunction.The aim of this study was to compare the diagnostic yield between the EAPCI and MVN algorithms in a large cohort of patients with ANOCA.Fractional flow reserve, coronary flow reserve, index of microcirculatory resistance, intravascular ultrasound, acetylcholine provocation, and myocardial bridging assessment were performed in patients referred for clinically suspected ANOCA.Among 516 patients, the prevalence of ANOCA, obstructive coronary artery disease, and noncardiac chest pain was 53.5%, 20.9%, and 25.6%, respectively, according to the EAPCI algorithm, compared with 88.2%, 3.3%, and 8.5% according to the MVN algorithm (P < 0.001 for overall difference). Of 132 patients classified as noncardiac chest pain by the EAPCI algorithm, 66.7% were reclassified into an ANOCA endotype using the MVN algorithm. Similarly, 84.3% of 108 patients diagnosed with obstructive coronary artery disease using the EAPCI algorithm were reclassified into an ANOCA endotype by the MVN algorithm. The mean Seattle Angina Questionnaire summary score was significantly lower in patients with cardiac chest pain compared with those with noncardiac chest pain (51.0 vs 56.1; P = 0.030) as defined by the MVN algorithm.The MVN algorithm results in a higher diagnostic yield for ANOCA endotypes compared with the EAPCI algorithm. Routine testing for myocardial bridging and endothelial dysfunction should be considered in patients with suspected ANOCA.
View details for DOI 10.1016/j.jcin.2025.09.049
View details for PubMedID 41443782
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Optimising primary care management of patients following acute coronary syndrome.
The British journal of general practice : the journal of the Royal College of General Practitioners
2025; 75 (760): 531-534
View details for DOI 10.3399/BJGP.2025.0403
View details for PubMedID 41167956