Effectiveness of the innovative Austrian phase III cardiac rehabilitation model on cardiovascular risk factors: a nationwide registry

Introduction The Austrian model of outpatient cardiac rehabilitation (CR) begins right after discharge from the acute care hospital. During phase II (OUT-II), it provides a facility-based, professionally supervised, multidisciplinary programme of 6 weeks. The subsequent, supervised phase III (OUT-III) lasts 6 months. In 2017, a 3–6 months lasting unsupervised home-based training has been added, which is followed by a 4-week facility-based evaluation and training period, called ‘refresher’. We aimed to assess the effectiveness of this programme using a nationwide registry. Methods Anthropometric data, resting blood pressure, lipid profile, maximum exercise capacity (P _max), anxiety (HADS-A) and depression (HADS-D) of all patients (n=1458) who participated in OUT-III between 1 January 2018 and 30 August 2022 were analysed. Data were assessed at the beginning of OUT-III (OUT-III _start), end of the supervised period (OUT-III _end) and during the refresher (OUT-III _refresher). Results From OUT-III _start to OUT-III _end, P _max (155±1.4 W to 167±1.6 W; p<0.001) and high-density lipoprotein (HDL) increased (49±0.4 mg/dL to 51±0.4 mg/dL; p<0.001), low-density lipoprotein (LDL) decreased (82±1.0 mg/dL to 79±1.1 mg/dL; p<0.001), while total cholesterol (CHOL) remained statistically unchanged (150±43.3 mg/dL to 149±43 mg/dL; p<0.999). From OUT-III _end to OUT-III _refresher, P _max slightly decreased (164±1.6 W; p<0.001), HDL further increased (52±0.5 mg/dL; p<0.020), whereas LDL (79±1.3 mg/dL; p<0.999) and CHOL remained unchanged (149±41 mg/dL; p<0.999). Anxiety (4.8±0.1 aU, 4.2±0.1 aU; p<0.001, 4.0±0.1 aU; p<0.001) and depression (3.7±0.1 aU, 34±0.1 aU; p<.001, 3.1±0.1 aU; p<0.001) continuously decreased from OUT-III _start to OUT-III _end and the OUT-III _refresher. Conclusion OUT-III CR resulted in sustained improvement in P _max, blood lipids, anxiety and depression.