Are cardiac rehabilitation pathways influenced by diabetes: A cohort study

Birgitte Bitsch Gadager, Lars Hermann Tang, Patrick Doherty, Marie Louise Svendsen, Kirstine Lærum Sibilitz, Alexander Harrison, Thomas Maribo

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Background: Cardiac rehabilitation (CR) is recommended following acute coronary syndrome (ACS). Diabetes is a common long-term condition associated with ACS, and the inclusion of these patients in CR has been less studied. This study examines the referral, uptake, and completion rates in the CR pathway for ACS patients with and without diabetes to identify potential barriers in the CR pathway. Methods: The study included patients aged 18 or above who were discharged after a diagnosis of ACS in the Central Denmark Region between 1 September 2017 and 31 August 2018. Diabetes information was obtained from three sources. Logistic regression models were used to examine the associations between having diabetes and the three outcomes: non-referral, non-uptake and non-completion. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). Results: A total of 2447 patients were eligible for the study, of which 457 (18.7%) had diabetes. Only non-uptake was found to be significantly associated with diabetes after adjustment for prespecified variables (OR = 1.38, 95% CI 1.01–1.90). Associations for non-referral (OR = 1.11, 95% CI 0.87–1.41) and non-completion (OR = 1.06, 95 %CI 0.73–1.53) were not found to be statistically significant between ACS patients with diabetes and those without diabetes. Conclusion: This study highlights a significant disparity in the uptake of CR between patients with and without diabetes following ACS, demonstrating that patients with diabetes require early promotion and increased assistance to enrol in CR.

Original languageEnglish
Article number132275
JournalInternational Journal of Cardiology
Pages (from-to)132275
Publication statusE-pub ahead of print - 14 Jun 2024


  • Acute Coronary Syndrome
  • Cardiac rehabilitation
  • Diabetes


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