This post was authored by Melissa Tracy, MD, FACC, section chief, non-invasive cardiology, Division of Cardiology at RUSH University Medical Center in Chicago, IL, and a member of the ACC’s Prevention of Cardiovascular Disease Section Leadership Council.

We are a country of opportunity. We are a society of diversity. We should all be treated with the best care possible. A recent update on the regional referral to cardiac rehabilitation (rehab) after angioplasty published in the Journal of the American College of Cardiology shows that we are not doing just that.  We must change from a SICK care model to a HEALTH care model.

Numerous studies, including results from the COURAGE Trial presented in 2007, and the “Impact of Cardiac Rehabilitation on Mortality and Cardiovascular Events After Percutaneous Coronary Intervention in the Community” by Goel, et. al. published May 2011 in Circulation, confirm the benefits of aggressive lifestyle modification with exercise, diet and weight loss to be equally beneficial for our patients compared to an invasive intervention.

Referral to a Phase II Cardiac Rehabilitation center was added to the ACC/AHA STEMI and NSTEMI guidelines in 2011 as a performance measure. Of all of the qualifiable cases for cardiac rehab, only approximately 30 percent are referred to a cardiac rehab center.  Of those referred, only an additional 30 percent will attend a cardiac rehab center.  And then, of those whom attend, not all of them even complete cardiac rehab.

A key factor in our patients attending and completing cardiac rehab is our approach, support, and follow through. It is our ethical and moral duty to do no harm. But, not referring to cardiac rehab should not be an option. We must be unified regardless of our regionality and patient population in our healthy preventive and secondary preventive medicine. Insurance companies must be heeded to see the costly benefit of preventive medicine. Prevention is key. We as a society cannot afford playing catch up.

My institution has received several regional and national accolades for our clinical medicine. We do not, though, currently have a cardiac rehab program. However, our leadership is recognizing this void and is poised to support our mission for traditional and intensive cardiac rehab. Why? Because it IS the right thing to do for our patients and all patients across the country.

Read a recent ACC Prevention Council perspective published in JACC on assessing cardiac rehab in patients with heart failure with reduced ejection fraction. Visit the Prevention clinical topic collection on ACC.org here, and learn more about the ACC’s Prevention of Cardiovascular Disease Section here.

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