Abstract 140: Characteristics and risk factors in patients completing and not completing a cardiac rehabilitation program at the University of Utah during its first year of participation with the American Association of Cardiovascular and Pulmonary Rehabilitation’s (AACVPR) Cardiac Rehabilitation Registry

Abstract

Introduction: Cardiac Rehabilitation (CR) is a multi-disciplinary secondary prevention program associated with decreased rates of re-infarction, cardiac and overall mortality in post myocardial infarction (MI) patients. Despite clear benefits, only 14-35% of MI survivors participate nationwide. Aim of this study was to describe the characteristics in CR eligible patients post MI, post percutaneous or surgical revascularization, post valvular, transplant or left ventricular assist device (LVAD) surgery who completed and did not complete CR. METHODS: Using reporting functions of the AACVPR, Society of Thoracic Surgery, and National Cardiovascular Data Registry, data was extracted for patients who attended at least one CR session from January to November 2013. Paired t-tests and multivariate regression were run to compare patients who did and did not complete CR. Additionally, data was compared to the registry’s nation-wide cohort of 20,671 patients from 607 CR programs. RESULTS: In 2013, 1550 patients (67% male, 33% female) were discharged from our institution with one of the above diagnoses, 700 (45%) were eligible for and referred to CR, of those referred 302 (43%) lived within a 40-mile radius of our program, only 128 (42%) enrolled in CR and 44 (15%) of those eligible completed CR. Of those enrolled in CR, mean age was 62 years; 76% male and 24% female. Travel distance to CR was the most significant predictor of enrollment and completion of CR. Characteristics of those completing and not completing CR are outlined in the table below. In addition to travel distance, independent predictors of program completion are age (65 v 59, p 0.02, OR 1.05) and metabolic syndrome (36% v 17%, p 0.03, OR 3.08). There was minimal difference between genders (data not shown), after completion of CR both had significant improvement in lipid profiles and exercise tolerance. When compared to national AACVPR registry, our data is overall similar except for lower smoking rates. CONCLUSION: Although our enrollment is higher than reported averages, less than half of eligible patients enroll in and completed CR. Distance to CR is a significant limiting factor. For our secondary prevention program to be affective, further investigation on increasing accessibility to CR and alternate ways of delivering CR will need to be piloted.