ClinicalTrials.gg
RecruitingNCT07722637Updated Jul 29, 2026

The Effect of Cardiac Rehabilitation on Ferroptosis in Patients With Coronary Artery Disease

An interventional study of Cardiac Rehabilitation in Coronary Artery Disease (CAD), Cardiac Rehab and Ferroptosis, sponsored by TC Erciyes University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-29.

Sponsored by TC Erciyes University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 6 months after the study started (first participant enrolled Jan 2026, registered Jul 2026).
  • Started Jan 2026; still recruiting 10 months later.

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Phase
Not applicable
Study type
Interventional
Enrollment
90
Allocation
Non-randomized
Ages
18 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 137 studies in Coronary Artery Disease with a site in Turkey — 33 open to participants now, 42 under way, 4 of them phase 3. Coronary Artery Disease · Turkey.

Planned enrollment
29th of 71
90 · median 70
Started
2026
with 24 others
No phase
58 of 137
17 open now
Primary completion
2026-11
later than 16 of 41 live
Registered
123rd of 137
by date

Among the 137 studies in Coronary Artery Disease with a site in Turkey, this one is the 29th largest by planned enrollment of the 71 interventional ones that give a count, is one of 25 that started in 2026, is one of 58 with no phase, reaches primary completion later than 16 of the 41 other live ones, and was the 123rd registered.

Coronary Artery Disease

4,862 studies on the registry are indexed under Coronary Artery Disease; 893 are open to participants now.

Browse Coronary Artery Disease studies →

Open to participants now

33 of the 137 studies in Coronary Artery Disease with a site in Turkey are open now. Recruiting first, the newest first:

27 more — sign in →

All 33 open studies →

A study can be open while its sites in Turkey have not opened yet or have stopped. Only those recruiting at a site in Turkey →

Who these studies take

Of the 589 Coronary Artery Disease studies recruiting now, 403 (68%) set no upper age limit and 68 (12%) stop at 75 or younger; 38 take children under 18; 48 take healthy volunteers.

This study: 18 Years to 75 Years · all sexes · healthy volunteers too.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 137 studies in Coronary Artery Disease with a site in Turkey, or all of them as a file.
02

Study summary

Coronary artery disease (CAD) remains a major global health concern and is the leading cause of cardiovascular mortality worldwide. Cardiac rehabilitation (CR) is a comprehensive, evidence-based intervention that integrates exercise training with optimal medical management and has been shown to improve clinical outcomes in patients with CAD. The primary objective of this study is to investigate the effects of cardiac rehabilitation on ferroptosis, an iron-dependent form of regulated cell death, in patients with coronary artery disease.

A total of 90 participants will be enrolled in the study after providing written informed consent. The study population will consist of three groups: 30 patients with CAD who participate in a cardiac rehabilitation program, 30 patients with CAD who voluntarily decline participation in cardiac rehabilitation, and 30 age- and sex-matched healthy volunteers without any known chronic disease. Peripheral venous blood samples will be collected from patients undergoing cardiac rehabilitation both before the initiation of the rehabilitation program and upon its completion. A single blood sample will be obtained from patients who decline participation in cardiac rehabilitation and from healthy control participants.

To evaluate ferroptosis-related molecular alterations, the expression levels of the ferroptosis-associated genes GPX4, SLC7A11, ACSL4, FSP1, NRF2, TFRC, and NCOA4 will be analyzed. In addition, serum concentrations of ferroptosis-related biomarkers, including free iron, 4-hydroxynonenal (4-HNE), malondialdehyde (MDA), and GPX4 protein, will be measured. The molecular and biochemical parameters will be compared among the three study groups, and changes in ferroptosis-related biomarkers before and after the cardiac rehabilitation program will be evaluated in patients undergoing cardiac rehabilitation.

Read the detailed description

Coronary artery disease (CAD) remains a major global public health challenge and is the leading cause of cardiovascular mortality worldwide. In recent years, ferroptosis, an iron-dependent form of regulated cell death, has emerged as a major focus of biomedical research. Characterized by excessive lipid peroxidation and the accumulation of reactive oxygen species (ROS), ferroptosis has provided new insights into the pathophysiology of CAD and represents a promising therapeutic target.

The pathophysiological significance of ferroptosis in cardiovascular diseases stems from its central role in dysregulated iron metabolism, lipid peroxidation, and excessive ROS accumulation. These mechanisms contribute substantially to the initiation and progression of CAD. Under pathological conditions such as ischemia and hypoxia, cardiomyocytes exhibit increased susceptibility to ferroptosis, leading to cellular dysfunction, myocardial injury, and impaired cardiac function.

Cardiac rehabilitation (CR) is a comprehensive, multidisciplinary intervention that integrates exercise training, cardiovascular risk factor management, lifestyle modification, and psychosocial support, and constitutes a cornerstone of contemporary CAD management. CR has been shown to slow or delay disease progression by targeting modifiable cardiovascular risk factors while improving quality of life, cardiac performance, exercise capacity, and cardiovascular symptoms. Furthermore, CR reduces anxiety, depression, and psychological stress, facilitates return to work, and promotes independence in activities of daily living.

Exercise-based cardiac rehabilitation is among the interventions supported by the strongest evidence for reducing mortality and morbidity in patients with CAD. Experimental studies in animal models have demonstrated that aerobic exercise suppresses ferroptosis, thereby reducing cardiomyocyte death, protecting the ischemic myocardium, and improving cardiac function. Conversely, induction of ferroptosis in cardiomyocytes has been shown to exacerbate ischemia-reperfusion injury. However, no clinical study has comprehensively investigated ferroptosis-related molecular alterations in patients with CAD or evaluated the effects of cardiac rehabilitation on these pathways in humans.

Therefore, the present study aims to compare ferroptosis-related molecular and biochemical biomarkers among patients with CAD undergoing cardiac rehabilitation, patients with CAD who voluntarily decline participation in cardiac rehabilitation, and healthy controls. In addition, changes in ferroptosis-related biomarkers before and after completion of the cardiac rehabilitation program will be evaluated in patients undergoing cardiac rehabilitation.

03

Conditions studied

  • Coronary Artery Disease (CAD)
  • Cardiac Rehab
  • Ferroptosis

Keywords

  • cardiac rehabilitation
  • ferroptosis
  • Coronary artery disease
04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Patients With Coronary Artery Disease (CAD):

  • Age between 18 and 75 years.
  • Diagnosis of coronary artery disease within the previous 3 months.
  • Eligible to participate in a cardiac rehabilitation program or voluntarily decline participation in the cardiac rehabilitation program.
  • Peak exercise capacity of ≥5 metabolic equivalents (METs).
  • Able to undergo cardiopulmonary exercise testing (CPET).
  • Able to understand the study procedures and provide written .

Healthy Controls:

  • Age between 18 and 75 years.
  • No history of coronary artery disease or other cardiovascular diseases.
  • No history of chronic systemic diseases, including diabetes mellitus, hypertension, chronic kidney disease, chronic liver disease, inflammatory or diseases, or .
  • Not receiving regular medication.
  • Able to provide written informed consent.

Exclusion criteria

Exclusion Criteria:

Patients With Coronary Artery Disease (CAD):

  • Decompensated heart failure.
  • Unstable angina pectoris.
  • Uncontrolled or complex ventricular arrhythmias.
  • Severe pulmonary hypertension.
  • Neurological, orthopedic, or musculoskeletal disorders limiting exercise performance.
  • Absolute to cardiopulmonary exercise testing or cardiac rehabilitation according to current clinical guidelines.
  • Chronic kidney failure or chronic liver disease.
  • Active infection.
  • Active inflammatory or disease.
  • Active or history of malignancy.
  • Pregnancy.
  • Cognitive or psychiatric disorders that would interfere with study participation or protocol compliance.

Healthy Controls:

  • History of coronary artery disease or other cardiovascular diseases.
  • History of chronic systemic diseases, including diabetes mellitus, hypertension, chronic kidney disease, chronic liver disease, inflammatory or autoimmune diseases, or malignancy.
  • Regular medication use within the previous 6 months.
  • Active infection.
  • Pregnancy.
  • Age younger than 18 years or older than 75 years.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
90 participants (estimated)

Study arms

  • Experimental
    Cardiac Rehabilitation Group

    Patients with coronary artery disease who will participate in a supervised cardiac rehabilitation program in addition to standard medical therapy. Peripheral venous blood samples will be collected before the initiation and after completion of the cardiac rehabilitation program for the assessment of ferroptosis-related gene expression and serum biomarkers.

    Behavioral: Cardiac Rehabilitation

  • No intervention
    CAD Patients Declining Cardiac Rehabilitation

    Patients with coronary artery disease who voluntarily decline participation in the cardiac rehabilitation program and continue to receive standard medical therapy. A single peripheral venous blood sample will be collected for the assessment of ferroptosis-related gene expression and serum biomarkers.

  • No intervention
    Healthy Control Group

    Age- and sex-matched healthy volunteers without known cardiovascular or chronic diseases. A single peripheral venous blood sample will be collected for the assessment of ferroptosis-related gene expression and serum biomarkers.

Interventions

  • BehavioralCardiac Rehabilitation

    A supervised, comprehensive cardiac rehabilitation program consisting of individualized aerobic and resistance exercise training, patient education, lifestyle modification, and cardiovascular risk factor management according to current clinical practice guidelines.

06

What researchers measure

Primary outcomes

  1. Change in GPX4 Gene Expression

    elative GPX4 gene expression in peripheral blood will be quantified using real-time quantitative polymerase chain reaction (RT-qPCR). Changes in GPX4 gene expression before and after completion of the cardiac rehabilitation program will be evaluated in patients undergoing cardiac rehabilitation. Baseline GPX4 gene expression levels will also be compared among patients undergoing cardiac rehabilitation, patients who decline participation in cardiac rehabilitation, and healthy control participants.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

Secondary outcomes

  1. Change in SLC7A11 Gene Expression

    Relative SLC7A11 gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks)

  2. Change in ACSL4 Gene Expression

    Relative ACSL4 gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  3. Change in FSP1 Gene Expression

    Relative FSP1 gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  4. Change in NRF2 Gene Expression

    Relative NRF2 gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  5. Change in TFRC Gene Expression

    Relative TFRC gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  6. Change in NCOA4 Gene Expression

    Relative NCOA4 gene expression will be measured using RT-qPCR. Expression levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  7. Change in Serum Free Iron Concentration

    Serum free iron concentration will be measured using a validated laboratory assay. Levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  8. Change in Serum 4-Hydroxynonenal (4-HNE) Concentration

    Serum 4-hydroxynonenal concentration will be measured using an enzyme-linked immunosorbent assay (ELISA). Levels will be compared among the three study groups, and changes before and after cardiac rehabilitation will be evaluated in the rehabilitation group.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

  9. Change in Peak Oxygen Uptake (Peak VO₂)

    Peak oxygen uptake (Peak VO₂) will be assessed using a symptom-limited cardiopulmonary exercise test (CPET). Changes in Peak VO₂ before and after completion of the cardiac rehabilitation program will be evaluated in patients undergoing cardiac rehabilitation. Baseline Peak VO₂ values will also be compared between patients undergoing cardiac rehabilitation and patients who decline participation in cardiac rehabilitation.

    Time frame: Baseline and immediately after completion of the cardiac rehabilitation program (6 weeks).

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Rao X, Huang X, Zhou Z, Lin X. An improvement of the 2^(-delta delta CT) method for quantitative real-time polymerase chain reaction data analysis. Biostat Bioinforma Biomath. 2013 Aug;3(3):71-85. PubMed 25558171 ↗
  • Cai W, Liu L, Shi X, Liu Y, Wang J, Fang X, Chen Z, Ai D, Zhu Y, Zhang X. Alox15/15-HpETE Aggravates Myocardial Ischemia-Reperfusion Injury by Promoting Cardiomyocyte Ferroptosis. Circulation. 2023 May 9;147(19):1444-1460. doi: 10.1161/CIRCULATIONAHA.122.060257. Epub 2023 Mar 29. PubMed 36987924 ↗
  • Srichaiyapol O, Saiboonjan B, Ngernpimai S, Ponsue C, Sa-Ingthong N, Thongmee P, Wonglakorn L, Sukkasem C, Kendal RP, Daduang J, Tavichakorntrakool R, Srisrattakarn A, Chanawong A, Wongwattanakul M, Lulitanond A, Tippayawat P. Enhanced performances of the short-PCR coupled lateral flow assay in the detection of Candida albicans in clinical blood samples. Asian Pac J Allergy Immunol. 2025 Jun 22. doi: 10.12932/AP-190125-2018. Online ahead of print. PubMed 40544374 ↗
  • Han J, Lin L, Fang Z, Xu D, Wang L, Ye B, Han X, Long X, Min J, Wu G, Liang G, Wang Y. Cardiomyocyte-derived USP13 protects hearts from hypertrophy via deubiquitinating and stabilizing STAT1 in male mice. Nat Commun. 2025 Jul 1;16(1):5927. doi: 10.1038/s41467-025-61028-1. PubMed 40593642 ↗
  • Piepoli MF, Corra U, Benzer W, Bjarnason-Wehrens B, Dendale P, Gaita D, McGee H, Mendes M, Niebauer J, Zwisler AD, Schmid JP; Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil. 2010 Feb;17(1):1-17. doi: 10.1097/HJR.0b013e3283313592. PubMed 19952757 ↗
  • Verdonk ML, Ludlow RF, Giangreco I, Rathi PC. Protein-Ligand Informatics Force Field (PLIff): Toward a Fully Knowledge Driven "Force Field" for Biomolecular Interactions. J Med Chem. 2016 Jul 28;59(14):6891-902. doi: 10.1021/acs.jmedchem.6b00716. Epub 2016 Jul 7. PubMed 27353137 ↗
  • Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016 Jan 5;2016(1):CD001800. doi: 10.1002/14651858.CD001800.pub3. PubMed 26730878 ↗
  • Zhang Z, Tang J, Song J, Xie M, Liu Y, Dong Z, Liu X, Li X, Zhang M, Chen Y, Shi H, Zhong J. Elabela alleviates ferroptosis, myocardial remodeling, fibrosis and heart dysfunction in hypertensive mice by modulating the IL-6/STAT3/GPX4 signaling. Free Radic Biol Med. 2022 Mar;181:130-142. doi: 10.1016/j.freeradbiomed.2022.01.020. Epub 2022 Feb 2. PubMed 35122997 ↗
  • Zhou Y, Zhou H, Hua L, Hou C, Jia Q, Chen J, Zhang S, Wang Y, He S, Jia E. Verification of ferroptosis and pyroptosis and identification of PTGS2 as the hub gene in human coronary artery atherosclerosis. Free Radic Biol Med. 2021 Aug 1;171:55-68. doi: 10.1016/j.freeradbiomed.2021.05.009. Epub 2021 May 8. PubMed 33974977 ↗
  • Wang Y, Wu J. Ferroptosis: a new strategy for cardiovascular disease. Front Cardiovasc Med. 2023 Sep 4;10:1241282. doi: 10.3389/fcvm.2023.1241282. eCollection 2023. PubMed 37731525 ↗
  • O'Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Jan 29;61(4):e78-e140. doi: 10.1016/j.jacc.2012.11.019. Epub 2012 Dec 17. No abstract available. PubMed 23256914 ↗

Individual participant data

Plan to share: No — It is not planned to make individual participant data from this study publicly available.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jan 2026 (actual). Primary completion is estimated for Nov 2026, 10 months after the start.

Of 753 non-industry interventional studies with no phase under Coronary Artery Disease, half reached primary completion within 33 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 53. This study's planned 10 months is below that.

Counting every sponsor, half of 930 studies reached it within 30 months; a quarter within 15 and three quarters within 50.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 19, 2026
First posted
Jul 23, 2026
StartActual
Jan 1, 2026
Primary completionEst.
Nov 15, 2026
CompletionEst.
Nov 15, 2026
Last update
Jul 29, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 29, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07722637
Responsible party
Hasan Kara (Assistant Professor, TC Erciyes University) — Principal investigator
First posted
Jul 23, 2026
Start date
Jan 1, 2026
Primary completion
Nov 15, 2026 (estimated)
Completion
Nov 15, 2026 (estimated)
Last update
Jul 29, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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