Please select the eligibility criteria that correspond to the clinical trial below.
Title: SheppheartCABG. A Randomised Clinical Trial of a Comprehensive Physical and Psycho-educative Rehabilitation Programme Plus Usual Care Versus Usual Care in Phase 1 Rehabilitation After Coronary Artery Bypass Grafting
Brief Summary: Background: Patients undergoing coronary artery bypass graft surgery often experience a range of problems and symptoms related to the procedure and the underlying heart disease.These problems include anxiety and depressive symptoms, immobility issues, complications such as wound seeping, neck and shoulder pains, interrupted and insufficient sleep. No studies have tested a combined intervention on phase 1 rehabilitation in coronary artery bypass graft surgery patients. However, randomised trials with either a physical or a mental part have been conducted with positive result, but evidence is lacking for a combined intervention. Before a large randomised trial was set up a pilot trial was conducted to evaluate the feasibility of patient recruitment and intervention: to test the safety and tolerability of the intervention by patients and to provide outcome data for sample size calculations. The SheppHeartCABG pilot showed trial feasibility, safety and sufficient inclusion rate and high compliance with most elements. Outcome data from the pilot trial has been used to sample size and power calculation in this randomised clinical trial.

Objective: The objective of this trial is to investigate the benefits and harms of a phase 1 comprehensive cardiac rehabilitation programme consisting of an exercise-training and a psycho-educative component, including plus treatment as usual in patients who undergo coronary artery bypass grafting.


Options:
A: Inclusion Criteria:

1. Age ≥18 years;
2. ability to read and provide informed consent to participate in the study;
3. History of a) acute coronary syndrome (unstable angina, non-ST segment elevation myocardial infarction or ST segment elevation myocardial infarction); or b) patients having undergone coronary catheterization for suspected coronary artery disease.

Exclusion Criteria:

1. Inability to provide informed consent;
2. does not have daily access to a smartphone compatible with the wearable device;
3. unable or unwilling to complete the baseline 6-minute walk test and return to perform the 6-minute walk test at 10 and 18 weeks;
4. already enrolled in an exercise cardiac rehabilitation program prior to hospital admission;
5. hemodynamic instability or New York Heart Association III-IV heart failure;
6. any other medical conditions that would prohibit participation in an 18-week physical activity program;
7. not being discharged to home if recently admitted.
B: Inclusion Criteria:

* acute myocardial infarction

Exclusion Criteria:

* ventricular tachyarrhythmia
* uncontrolled hypertension (systolic blood pressure \>180 mmHg or diastolic blood pressure \>100 mmHg)
* significant valvular disease
* unstable angina pectoris
* reduced left ventricular function (ejection fraction \< 45%)
* abnormal hemodynamic response
* myocardial ischemia and/or severe ventricular arrhythmias during baseline exercise testing
* uncontrolled metabolic disease (e.g. uncontrolled diabetes or thyroid disease)
* presence of pulmonary and renal co-morbidities
* peripheral artery disease and/or orthopedic limitations
C: Inclusion Criteria:

* Patients 18 years or older with ischaemic heart disease,
* Who have to undergo elective coronary artery bypass grafting,
* Who speak and understand Danish and
* Who provide a written informed consent will be included.

Exclusion Criteria:

Patients will be excluded from the trial:

* Patients at intermediate or high risk to their cardiovascular status according to guidelines,
* Patients with neurological or orthopaedic deficits which prevent training and
* Patients who do not wish to participate.
D: Inclusion Criteria:

* Class I to III angina pectoris (classified according to the Canadian Cardiovascular Society \[CCS\])with documented myocardial ischemia or coronary artery disease on angiography
* Ability to read and speak English to a level allowing satisfactory completion of written questionnaires and to understand instruction during the exercise programme.

Exclusion Criteria:

* Acute coronary syndromes or recent myocardial infarction (\<2 months)
* Left main coronary artery stenosis \>25% or high-grade proximal left anterior descending artery stenosis
* Known reduced left ventricular function (ejection fraction \<40%)
* Significant valvular heart disease
* Insulin-dependent diabetes mellitus
* Occupational, orthopedic, and other conditions that preclude regular exercise
* Patients whose ECG prevents interpretation of an exercise test (LBBB, RBBB, pacemaker implantation).
* Patients who already perform greater than 30min continuous exercise three times weekly (self-reported).

Answer: C