Clinical practice guideline for cardiac rehabilitation in Korea: Recommendations for cardiac rehabilitation and secondary prevention after acute coronary syndrome

Chul Kim, Jidong Sung, Jong Hwa Lee, Won Seok Kim, Goo Joo Lee, Sungju Jee, Il Young Jung, Ueon Woo Rah, Byung Ok Kim, Kyoung Hyo Choi, Bum Sun Kwon, Seung Don Yoo, Heui Je Bang, Hyung Ik Shin, Yong Wook Kim, Heeyoune Jung, Eung Ju Kim, Jung Hwan Lee, In Hyun Jung, Jae Seung JungJong Young Lee, Jae Young Han, Eun Young Han, Yu Hui Won, Woosik Han, Sora Baek, Kyung Lim Joa, Sook Joung Lee, Ae Ryoung Kim, So Young Lee, Jihee Kim, Hee Eun Choi, Byeong Ju Lee, Soon Kim

    Research output: Contribution to journalReview articlepeer-review

    25 Citations (Scopus)


    Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

    Original languageEnglish
    Pages (from-to)1066-1111
    Number of pages46
    JournalKorean Circulation Journal
    Issue number11
    Publication statusPublished - 2019

    Bibliographical note

    Funding Information:
    This study was funded by the Ministry of Health and Welfare (MOHW) as part of the Health and Medical Technology Research and Development Project of the Korea Health Industry Development Institute (KHIDI) (Project number: HC17C0063, study period: November 1,2018 to October 31, 2018). There has not been any influence from the KHIDI and National Evidence-Based Healthcare Collaborating Agency throughout the entire process of the CPGs development, and no funding has been received from other academic societies, organizations, and interest groups. The authors express their gratitude to Kyung Pyo Hong, Samsung Medical Center, Yun-Hee Kim, Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Sung-Bo Sim, Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine, Won-Hah Park, Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kun-Sei Lee, Department of Preventive Medicine, School of Medicine, Konkuk University, Soo Young Kim, Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Woong Ju, School of Medicine, Ewha Womans University, Sae Young Jae, Department of Sport Science, Graduate School of Urban Public Health, University of Seoul, Mi Ja Jang, Samsung Medical Center, Hye Jeong Kim, Inje University Sanggye Paik Hospital, Jung-Ho Youn, Mediplex Sejong Hospital, Song Mi Lee, Severance Hospital, Seungmin Lee, Department of Food and Nutrition, Sungshin Women's University, Jeong Ju Lee, Kyunghee University Hospital at Gangdong for their effort in expert's advices. All researchers involved in the development of these CPGs declare no conflict of interest while participating in the development process.

    Publisher Copyright:
    Copyright © 2019. The Korean Society of Cardiology.


    • Acute coronary syndrome
    • Cardiac rehabilitation
    • Clinical practice guideline
    • Mortality
    • Secondary prevention

    ASJC Scopus subject areas

    • Internal Medicine
    • Cardiology and Cardiovascular Medicine


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