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Research Letter |

Cardiac Rehabilitation Use Among Veterans With Ischemic Heart Disease

David W. Schopfer, MD, MAS1; Steven Takemoto, PhD1; Kelly Allsup, BS2; Christian D. Helfrich, PhD3; P. Michael Ho, MD4,5; Daniel E. Forman, MD2,6,7,8; Mary A. Whooley, MD1,9,10
[+] Author Affiliations
1Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California
2New England Geriatric Research, Education, and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
3Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Healthcare System, Seattle, Washington
4Division of Cardiology, Denver Veterans Affairs Medical Center, Denver, Colorado
5Department of Medicine, Division of Cardiology, University of Colorado Health Sciences Center, Denver
6Division of Cardiovascular Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
7Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts
8Department of Medicine, Harvard Medical School, Boston, Massachusetts
9Department of Medicine, University of California, San Francisco
10Department of Epidemiology and Biostatistics, University of California, San Francisco
JAMA Intern Med. 2014;174(10):1687-1689. doi:10.1001/jamainternmed.2014.3441.
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Referral to exercise-based cardiac rehabilitation (CR) is 1 of 9 performance measures for secondary prevention after hospitalization for myocardial infarction (MI), percutaneous coronary intervention (PCI), and/or coronary artery bypass graft (CABG).1,2 Although CR programs significantly reduce morbidity and mortality in patients with ischemic heart disease (IHD),3 they are vastly underused among US Medicare beneficiaries.4 The use of CR programs in the Veterans Health Administration (VA) has not been described. Therefore, we sought to determine (1) the proportion of eligible veterans with IHD who participate in CR, (2) whether the presence of an on-site CR program is associated with greater participation, and (3) the characteristics of the CR participants.

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Figure.
Proportion of Eligible Patients Participating in Cardiac Rehabilitation (CR) at Veterans Health Administration (VA) Facilities With and Without CR Programs

The study was conducted from October 1, 2006, to September 30, 2012. All differences were significant at P < .001. CABG indicates coronary artery bypass graft; IHD, ischemic heart disease; MI, myocardial infarction; and PCI, percutaneous coronary intervention.

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