Cardiac Rehabilitation in Patients with Chronic Coronary Syndromes: Does Obesity Affect Outcomes?

Obesity is highly prevalent among patients with chronic coronary syndrome (CCS) and is associated with impaired functional capacity and increased cardiovascular risk. Cardiac rehabilitation (CR) is a key intervention shown to improve exercise capacity and outcomes in this population.

This study aimed to compare the effectiveness of CR between obese and non-obese patients with CCS.

In this retrospective study, we analyzed data from CCS patients who completed an exercise-based CR program between January 2020 and December 2024. Participants were categorized into obese (body mass index [BMI] ≥ 30 kg/m²) and non-obese (BMI < 30 kg/m²) groups. Cardiopulmonary exercise testing (CPX) parameters including VO2 peak (ml/kg/min), VO2 peak (%), VO2 peak (L/min), and VO2 at anaerobic threshold (AT) (%) were assessed before and after the CR program.

The records of 92 obese and 124 non-obese patients were analyzed. At baseline, the obese patients had significantly lower VO2 peak values (p = 0.003). However, post-rehabilitation, both groups demonstrated significant improvements in CPX parameters, with the obese patients demonstrating greater percentage gains in VO2 peak (%) (p < 0.001) and VO2 at AT (p < 0.001). CR adherence did not differ significantly between groups.

Despite lower baseline functional capacity, the obese patients had substantial improvements in exercise capacity post-CR, comparable to or exceeding those of non-obese individuals. These findings highlight the importance of CR in managing obesity-related cardiovascular risks and emphasize the need to promote CR participation among obese patients.