234 Cardiac rehabilitation compliance, are we meeting guidelines?

Introduction Coronary heart disease (CHD) is a leading cause of death in the UK with estimated 2.3 million people living with coronary artery disease 1. Effective cardiac rehabilitation can improve mortality, quality of life and reduce further hospital admission in patients with CHD. There is an absolute risk reduction in mortality from 10.4% to 7.6% in patients receiving cardiac rehab after an acute coronary event 2. The British association of cardiovascular prevention and rehabilitation (BACPR) and NICE have established guidelines for the rehabilitation process after an acute coronary event 2–3. Up to 2023, the completion rate of rehabilitation is 70–80% across the UK 4. Our aim was to determine if the local practice at University Hospital Sussex NHS Foundation Trust meet the national guidance for secondary cardiovascular disease prevention and rehabilitation. Methods Data was obtained using MINAP 5 database from January 2022 to January 2023. This was randomised using Excel's RAND formula of which 100 patient cases were analysed. 65 patients were males and 35 were females. 12 patients were aged below 60 years.*Table* Data was collected using clinical documents, hospital prescribing systems and summary care records on the hospital electronic systems. Emphasis was placed on whether secondary prevention measures were initiated or optimised during admission and following review by the cardiac rehab team. Results 56 patients were managed medically, 34 patients had percutaneous coronary intervention, 6 had coronary bypass graft surgery and 4 had no treatment. During admission, HBA1C and lipid profile were checked in 39% and 56% of patients, respectively. Lipoprotein(a) was checked in 12 out of 30 eligible patients, as per HEART UK guidelines 6. 61% of the patients were started on statin therapy of which 9% had their dose uptitrated. Dual antiplatelets were started for 79% of patients, 4% were only on aspirin post CABG and 11% were on DOAC/warfarin. 78 patients were followed up by the cardiac rehab team (figure 1). GP was informed and changes proposed to lipid therapy if targets (40% decrease in non-HDL or if LDL below 1.8 mmol/L) are not achieved on repeat lipid profiles (figure 2). Conclusion 79% patients were reviewed by the cardiac rehab team following discharge from the hospital. The secondary preventive medications were started or uptitrated in more than 70% of patients. Lipid targets were achieved and the GP was informed for 23% and 32% of patients respectively. During admission, HBA1c, lipid profile and lipoprotein(a) were not adequately checked. Overall, the results met the national completion rate of 70–80% in line with National Audit of Cardiac Rehabilitation Quality and Outcomes Report 20234. Although 79% of patients were seen, room for improvement remains. Conflict of Interest None