Socio-geographical factors associated with cardiac rehabilitation participation after percutaneous coronary intervention: a registry-based cohort study from France - Report - MDSpire
Advertisement
Socio-geographical factors associated with cardiac rehabilitation participation after percutaneous coronary intervention: a registry-based cohort study from France
Socio-Geographical Factors Affect Cardiac Rehabilitation Participation Post-PCI in France
Overview
This cohort study of 19,002 French patients post-percutaneous coronary intervention (PCI) found low cardiac rehabilitation (CR) participation rates: 33% for acute coronary syndrome (ACS) and 15% for chronic coronary syndrome (CCS). Distance to CR centers reduced participation in ACS patients, while socioeconomic deprivation decreased CR use in CCS patients; general practitioner accessibility showed no impact.
Background
Coronary heart disease (CHD) is a leading cause of mortality globally, with PCI as a common revascularization treatment for acute and chronic coronary syndromes. Cardiac rehabilitation (CR) is strongly recommended post-PCI to improve outcomes, yet participation remains suboptimal worldwide. Socio-geographical factors such as social deprivation, distance to CR centers, and healthcare accessibility may influence CR uptake, but their roles are not fully understood. Understanding these determinants is critical to addressing disparities and improving secondary prevention.
Data Highlights
Patient Group
Total Patients
CR Participation
Participation Rate (%)
Overall
19,002
5,073
26.7
ACS
12,337
4,071
33.0
CCS
6,665
1,002
15.0
Key Findings
Only 33% of ACS patients and 15% of CCS patients participated in CR within one year post-PCI.
ACS patients living more than 25 km from a CR center had significantly lower participation at 3 months (OR=0.83, 95% CI: 0.70–0.99, P=0.023).
CCS patients from the most socioeconomically advantaged areas were more likely to participate in CR at 3 months (OR=0.62, 95% CI: 0.44–0.88, P=0.002) and 6 months (OR=0.59, 95% CI: 0.42–0.82, P<0.001).
General practitioner accessibility did not significantly influence CR participation in either ACS or CCS patients.
CR participation rates remain low despite established clinical benefits and national recommendations.
Clinical Implications
Clinicians and health policymakers should recognize that geographic distance and socioeconomic status are key barriers to CR participation post-PCI. Strategies such as tele-rehabilitation, automatic referral systems, and expanding CR service coverage could mitigate these disparities. Tailored interventions targeting patients in deprived areas and those living far from CR centers may improve uptake and outcomes.
Conclusion
Socio-geographical inequalities significantly affect cardiac rehabilitation participation following PCI in France, with distance impacting ACS patients and socioeconomic deprivation affecting CCS patients. Addressing these disparities through targeted health policies and innovative care pathways is essential to optimize secondary prevention.
References
Study Authors/France PCI Registry/2024 -- Influence of Socio-Geographical Variables on Participation in Cardiac Rehabilitation Following PCI
Data presented at the American College of Cardiology 75th Annual Scientific Session linked pregnancy-associated SCAD to more severe presentation and higher in-hospital major adverse cardiovascular events.
