Background
Following percutaneous coronary intervention (PCI), outpatient cardiac rehabilitation
(CR) is essential for secondary prevention. However uptake of CR is suboptimal, despite
strong evidence demonstrating benefits. The aim of this study was to identify contemporary
trends and predictors of CR referral of PCI patients in Victoria.
Methods
A prospective, observational study using data extracted from the Victorian Cardiac
Outcomes Registry was undertaken. A total of 41,739 patients were discharged following
PCI over the study period (2017–2020) and included for analysis.
Results
Cardiac rehabilitation referral was 85%, with an increasing trend over time (p<0.001).
Multivariable modelling identifying the independent predictors of CR referral included
hospitals with high volumes of ST-elevation myocardial infarction patients (STEMI)
(OR 4.89, 95% CI 4.41–5.20), STEMI diagnosis (OR 1.90, 95% CI 1.69–2.14), or treatment
in a private hospital (OR 1.45, 95% CI 1.33–1.57). Predictors of non-referral included
cardiogenic shock (OR 0.54, 95% CI 0.41–0.71), aged over 75 years (OR 0.62, 95% CI
0.57–0.68) and previous PCI (OR 0.66, 95% CI 0.62–0.70). Percutaneous coronary intervention
patients with an acute coronary syndrome who were referred to CR were also more likely
to be prescribed four or more major preventive pharmacotherapies, compared to those
who were not referred (90% vs 82.1%, p<0.001).
Conclusion
Our contemporary multicentre analysis showed generally high CR referral rates which
have increased over time. However, more effort is needed to target patients treated
in the public sector, low volume STEMI hospitals or with short lengths of stay.
Keywords
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Article info
Publication history
Published online: May 25, 2022
Accepted:
April 7,
2022
Received in revised form:
March 30,
2022
Received:
December 19,
2021
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
