Evidence map›Paper›PMID 41627303›Full record

Observational studyJournal of cardiopulmonary rehabilitation and prevention2026

Cardiac Rehabilitation Program-Related Factors Associated With Morbidity Among Patients in Low-Resource Settings: Analysis From the International Cardiac Rehabilitation Registry.

Sana A Elashie, Sherry L Grace, Farzana A Hashmi, Leong Be Kim, Masoumeh Sadeghi, Gabriela L M Ghisi, Jorge A Lara Vargas, Martin Heine, Manal S Al Shamari, Maria J Sepulveda and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Journal of cardiopulmonary rehabilitation and prevention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sana A ElashieAuthor Affiliations: Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar (Ms Elashie and Dr Turk-Adawi); Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, Canada (Drs Grace and Ghisi); KITE - Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada (Drs Grace and Ghisi); Preventive Cardiology and Rehabilitation, Tabba Heart Institute, Karachi, Pakistan (Dr Hashmi); Department of Rehabilitation Medicine, Cardiac Rehabilitation Program, Sarawak Heart Center, Kota Samarahan, Sarawak, Malaysia (Dr Kim); Department of Cardiology, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran (Dr Sadeghi); Servicio de Rehabilitacíon Cardiaca, Departamento de Cardiocirugía, Centro Médico Nacional, Mexico City, Ciudad de México, Mexico (Dr Vargas); Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherland (Dr Heine); Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar (Dr Al Shamari); and Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile (Ms Sepulveda).
Sherry L Grace
Farzana A Hashmi
Leong Be Kim
Masoumeh Sadeghi
Gabriela L M Ghisi
Jorge A Lara Vargas
Martin Heine
Manal S Al Shamari
Maria J Sepulveda
Karam I Turk-Adawi
ICRR Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCardiovascular disease is a leading cause of morbidity globally, particularly in low-resource settings. The effectiveness of cardiac rehabilitation (CR) is well-established; however, the nature of services in low-resource settings differs. This study sought to investigate program characteristics associated with lower all-cause morbidity among CR participants from low-resource settings.

methodsThis was a prospective observational study analyzing the International Council of Cardiovascular Prevention and Rehabilitation's International CR Registry. Programs with annual assessment data at the time of study were included, and their characteristics were assessed in a survey. Self and program-reported patient morbidity included all- and cardiac-cause hospitalization, emergency department visits, cardiovascular disease events, and procedures 1 year from initial assessment. A multilevel modified Poisson regression model was used to account for clustering of patients within CR programs, estimating the adjusted incidence rate ratios (IRR) for morbidity.

resultsOf the 690 patients from programs in 6 countries across 4 regions (Colombia, Iran, Malaysia, Mexico, Pakistan, and Qatar), 637 (92%) were retained, of which 479 (75%) had morbidity data. Seven patients died and 93 suffered morbidity; this was most commonly noncardiac hospitalization (29 events) and emergency department visits (18 events). The regression analysis revealed a significantly lower incidence of morbidity associated with the following program factors: higher number of risk factors assessed (IRR = 0.55: 95% CI, 0.39-0.77), greater number of CR health care professionals (IRR = 0.76: 95% CI, 0.65-0.89), and CR located in academic/tertiary care institution (IRR = 0.61: 95% CI, 0.50-0.75).

conclusionGlobally, CR programs could benefit from prioritizing comprehensive risk assessment and strengthening CR teams to potentially reduce morbidity.

Indexed as

Cardiac RehabilitationAgedEmergency Room VisitsFemaleHospitalizationHumansMaleMiddle AgedMorbidityProspective StudiesRegistriesResource-Limited Settingscardiac rehabilitationhospitalizationlow-resource settingmorbidityquality of health careregistries

Identifiers

PMID41627303
PMCPMC13286112

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.