Current control of lipid profile after a contemporary cardiac rehabilitation program: insights from interim analysis of the spanish national ReCardio registry

Abstract Objective The objective of this study is to evaluate the clinical characteristics and lipid control of patients completing contemporary cardiac rehabilitation (CR) programs across Spain, using data from the prospective, multicentre ReCardio national registry. Methods We conducted a prospective, multicentre, cross-sectional registry including consecutive adult patients with ischaemic heart disease (acute coronary syndrome, chronic coronary syndrome, or prior coronary revascularization) who completed a cardiac rehabilitation program in seven participating Spanish centres between October 2024 and October 2025. Baseline data at start of CR (such as total cholesterol) refers to the recorded value upon first visit to CR, that is, after the patient has been discharged from hospital and medical treatment has been optimised post acute event of ischaemic heart disease. Results A total of 244 patients were included in the study, of whom 82% were male, with a mean age of 61.3 ± 10.3 years. Contact with tobacco was reported in 67% of the cohort. 94% presented with acute coronary syndrome, comprising 53% with STEMI and 40% with NSTEMI. 56% of patients had hypertension, 24% had diabetes mellitus, and 26% had pre-diabetes. Dyslipidaemia was present in 84% of patients, 20% had a normal body mass index (BMI 18.5–24.9 kg/m²), 50% were overweight (BMI 25–29.9 kg/m²), and 30% were classified as obese (BMI 30 kg/m²). Significant improvements in lipid parameters were observed during the cardiac rehabilitation (CR) program. Mean total cholesterol decreased from 141.8 ± 48.9 mg/dL at start of CR to 113.8 ± 21.9 mg/dL, corresponding to a mean reduction of −28.0 ± 51.4 mg/dL, (p 0.001). Median LDL cholesterol dropped from 70.5 mg/dL (Q1–Q3: 46.5–114.2) at start of CR to 52.0 mg/dL (Q1–Q3: 41.2–60.0) at end of CR. The median change was −12.9 mg/dL (Q1–Q3: −60.7 to −0.2), (p 0.001). Triglycerides also improved, decreasing from a mean of 123.9 ± 50.7 mg/dL at start of CR to 101.2 ± 78.8 mg/dL at end of CR, with a mean reduction of −22.6 ± 70.4 mg/dL, (p 0.001). Lipoprotein(a), measured in mg/dL had a median concentration of 31.5 mg/dL (IQR 73), of which 40.4% were over 50mg/dL. Lipoprotein (a) values measured in nmol/L were 85 nmol/L (IQR 157.2), of which 32.7% had values above 150 nmol/L. At the end of the CR program, the vast majority of patients were receiving intensive lipid-lowering therapy. Statins were prescribed in 96% of the cohort, and ezetimibe in 83%. Additional lipid-modifying agents included, icosapent ethyl in 5%, PCSK9 inhibitors in 4% of patients, and inclisiran in 1%. Conclusions This preliminary assessment of a contemporary cohort of patients that participate in CR in Spain, shows a significant improvement in lipid profile, underscoring the value of CR as a comprehensive tool for achieving lipid-management goals and optimizing treatment in patients with ischaemic heart disease. The use of new lipid lowering therapies remains low.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.