HMN 2026: How Cardiac rehab saves lives post heart attack, yet more than 80% of patients don’t access it

New research has found that every year almost 400,000 Australians fail to access cardiac rehabilitation programs following conditions like a heart attack, despite strong evidence that doing so significantly reduces the risk of dying from another cardiac event.

The first study in 20 years of Victorian heart attack patients has shown that people who have had a serious cardiac event are four times more likely to die from another attack if they don’t attend cardiac rehabilitation programs. Despite this, a new Monash-led study has found that only one in five cardiac patients in Victoria attend these programs.

Importantly, the study shows there is a very strong link between a cardiac patient who undergoes rehabilitation following a heart attack and a return to full health.

The study of more than 7,100 Victorian patients across 13 public hospitals, published in the International Journal of Cardiology, was led by Dr. Susie Cartledge from Monash University, for the first time, linked the Vic Cardiac Outcomes Registry (VCOR) to the Vic Integrated Non-Admitted Health (VINAH) datasets between 2019 and 2021.

At 12 months post-cardiac event, cardiac rehabilitation attendees had lower mortality and fewer unplanned readmissions.

“The reduced risk of dying from further cardiac events was directly related to the number of cardiac rehabilitation sessions attended,” Dr. Susie Cartledge said.

“Mortality was four times higher in those who didn’t attend any sessions compared to those who attended the full six-week program.”

Cardiac rehabilitation participants were defined as either nonattenders, having low attendance (1–5 sessions) or high attendance (6 or more sessions).

The study found that patients who attended cardiac rehabilitation were younger (less than 64 years old), more likely to live with family, more likely to have a diagnosis of serious heart disease (fully or partially blocked coronary artery), and more likely to have experienced a longer length of stay in the hospital.

Cardiac outpatient programs are delivered over six to eight weeks, combining self-management education, tailored exercise and psychosocial support.

“Despite these programs having been shown to significantly reduce repeat heart attacks, short-term all-cause hospitalization, increase health-related quality of life and reduce long-term cardiovascular mortality, while being cost-effective, their uptake in Victoria remains very poor,” Cartledge said.

The study also revealed that one of the main reasons for low uptake of rehabilitation is a lack of patients being referred to these programs by their cardiologists.

“Less than half of eligible Australians are referred to cardiac rehabilitation after an acute cardiac event,” Cartledge said, referring to previous studies from her lab using the same dataset (VCOR), which showed that the referral rate for PCI patients was high at 85%, “…so it was really disappointing to see that only 19.3% of those went to cardiac rehab.

“Lack of attendance at cardiac rehabilitation programs is multifaceted but is driven by lack of referral, lack of patient’s understanding about the importance of attending, and the fragmented systems between inpatient and outpatient care.”

Unlike countries such as Austria, Canada, Denmark, the UK and the U.S., Australia does not have a national cardiac rehabilitation registry. Thus, the cardiac patient’s journey from inpatient to outpatient care has not been examined in Victoria for more than two decades.

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