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Title: Trends and Predictors of Cardiac Rehabilitation Referral Following Percutaneous Coronary Intervention: A Prospective, Multi-Site Study of 41,739 Patients From the Victorian Cardiac Outcomes Registry (2017-2020).
Austin Authors: Cartledge, Susie;Driscoll, Andrea ;Dinh, Diem;O'Neil, Adrienne;Thomas, Emma;Brennan, Angela L;Liew, Danny;Lefkovits, Jeffrey;Stub, Dion
Affiliation: Baker Heart and Diabetes Institute, Melbourne, Vic, Australia..
Department of Cardiology, Western Health, Melbourne, Vic, Australia..
Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Vic, Australia..
School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia..
Department of Cardiology, The Alfred Hospital, Melbourne, Vic, Australia..
School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia..
Food and Mood Centre, IMPACT Institute, Deakin University, Geelong, Vic, Australia..
Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia..
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia..
Issue Date: 25-May-2022
Date: 2022
Publication information: Heart, Lung & Circulation 2022; 31(9): 1247-1254
Abstract: 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. 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. 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). 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.
DOI: 10.1016/j.hlc.2022.04.050
ORCID: 0000-0002-6837-0249
Journal: Heart, lung & circulation
PubMed URL: 35643797
PubMed URL:
Type: Journal Article
Subjects: Cardiac rehabilitation
Percutaneous coronary intervention
Secondary prevention
Appears in Collections:Journal articles

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