Who is cardiac rehabilitation for?

Cardiac rehabilitation is recommended for people who have had a heart attack, cardiac stent placement (percutaneous coronary intervention), bypass surgery, or heart failure hospitalisation. It is typically a 6 to 12-week structured program combining supervised exercise, education on heart-healthy lifestyle, and psychological support. It has strong evidence behind it for reducing the risk of future events.

What if I was never referred to cardiac rehab?

You can ask for a referral at any point after a cardiac event or procedure. Raise it at your next GP appointment as a specific agenda item. If a hospital or centre-based program does not fit your schedule or location, ask whether home-based or telehealth cardiac rehabilitation is available — evidence increasingly supports both as effective alternatives to in-person attendance.

Eight in ten cardiac patients skip rehab — and the risk is real

What just happened

An Australian study has put hard numbers on something clinicians have known qualitatively for years: most cardiac patients never make it to rehabilitation.

The research, led by Monash University and published in the International Journal of Cardiology, followed 37,191 adults who underwent percutaneous coronary intervention (PCI) — cardiac stent placement — in Victorian public hospitals between January 2019 and December 2021. Only 19.3% attended at least one public cardiac rehabilitation session. Roughly 80% did not engage with a program designed specifically to reduce their risk of a second event.

The one-year mortality figures are difficult to dismiss. Patients who attended rehabilitation had a 1% mortality rate at 12 months. Those who did not: 4.9% — nearly five times higher.

The researchers acknowledge that COVID-19 lockdowns during the study period were a confounding factor that suppressed attendance further. They maintain nonetheless that the findings reflect a systemic and ongoing failure, not a pandemic artefact. The “leaky pipeline” framing describes exactly that: patients lost at multiple points — at discharge through non-referral, at referral through non-attendance, and through early dropout. The gap is not one hole. It is a pipe that leaks all the way down.

The both-and

The 80% who didn’t go: barrier or bypass?

The framing that 80% “skipped” cardiac rehab risks misattributing this as patient-side failure — the implication that people were offered something and turned it down. The AusDoc report makes clear that fewer than half of eligible patients are even referred to cardiac rehabilitation at the time of discharge, and fewer than a quarter receive guideline-recommended post-discharge care in total.

The dropout is partly patient-side — cardiac rehab requires repeated attendance over weeks, often at times that compete with work, caring responsibilities, and the fatigue of recovery. But it is substantially system-side too. The Heart Foundation recommends cardiac rehabilitation for all eligible patients after an acute coronary event. The implementation reality in Victorian public hospitals during this study period bore little resemblance to that recommendation.

This distinction matters for what it implies about the solution. A patient asking “why was I not referred?” is raising a system accountability question. A patient asking “why did I not attend?” is raising a personal access question. Both matter. Both require different responses — and conflating them obscures the fact that a significant portion of the 80% never had the chance to make a choice at all.

The women-specific story inside this data

Cardiac rehabilitation has a well-documented gender gap that this study does not resolve but sits squarely within. Women are under-referred to cardiac rehabilitation programs more often than men. When referred, they attend at lower rates. The barriers compound: women more often carry primary caring responsibilities that make structured weekly attendance difficult; they more often lack reliable transport to centre-based programs; and there remains a persistent failure to recognise that cardiovascular disease is a women’s disease at all.

A 45-year-old woman who has had a stent placed or experienced an acute coronary event is at meaningful ongoing risk. The secondary prevention evidence base — cardiac rehabilitation, medication adherence, lifestyle modification, psychological support — is strong. Her odds of being among the 19.3% who access it are, if anything, lower than the already-low average.

2 cents

The practical take from this data is not anxiety about a system failing you. It is knowing the question to ask, so that you or someone you are supporting ends up in the 19.3% rather than the 80%.

If you or a family member has had a heart attack, cardiac stent, bypass surgery, or acute coronary event: ask directly — at discharge, or at the first post-discharge GP appointment — “what is the plan for cardiac rehabilitation, and how do I access it?” This is guideline-recommended care. Asking for it is not demanding something extra.

If the answer is a referral to a program that does not fit your schedule or location, ask whether home-based or telehealth cardiac rehabilitation is available. Evidence supports both as effective alternatives to centre-based attendance. GPs can initiate this referral even if the hospital did not.

Verdict: yes — the data is Australian, the gap is real and measurable, and knowing to ask for a rehabilitation referral is concrete and immediately actionable.

Sources cited

AusDoc — ‘Leaky pipeline’: 80% of cardiac patients skip rehab in Aussie study. 6 July 2026. https://www.ausdoc.com.au/news/leaky-pipeline-80-of-cardiac-patients-skip-rehab-in-aussie-study/
Heart Foundation Australia — Cardiac rehabilitation recommendations. https://www.heartfoundation.org.au
International Journal of Cardiology — Cardiac rehabilitation attendance after percutaneous coronary intervention in Victoria (Monash University, 2026). Via AusDoc.