Planning a cardiac rehabilitation unit: insights from an acute coronary syndrome admissions registry

Background Cardiac rehabilitation programs improve patient outcomes and reduce healthcare costs. However, many hospitals still do not have dedicated rehabilitation units. Purpose To assess the feasibility of establishing a cardiac rehabilitation unit in a local general hospital by analysing one year of acute coronary syndrome (ACS) admissions. Methods We conducted a retrospective analysis of all patients admitted with ACS to our hospital between September 2023 and August 2024. Data were processed using IBM SPSS Statistics. Results A total of 86 patients were included (median age: 70 years; range: 32–91), 81% were male, and 92% were of Western European origin. Non-ST-elevation ACS (NSTEACS) accounted for 87% of cases (NSTEMI: 57%, unstable angina: 30%). The most common cardiovascular risk factors were hypertension (70%), diabetes (37%), prior ischemic heart disease (36%), and active smoking (26%). Regarding lipid profiles, 37 patients had isolated elevated LDL (median: 97 mg/dL), 3 had isolated hypertriglyceridemia (median: 239 mg/dL), and 22 had both elevated LDL (median: 116 mg/dL) and triglycerides (median: 192 mg/dL). Only 8% of patients were classified as high-risk for cardiac rehabilitation due to LVEF <40%. Based on these findings and considering resource limitations, we propose an 8–12-week rehabilitation program that would accommodate approximately 7 patients per month, following a hybrid model with virtual follow-up for younger and digitally proficient patients. The required infrastructure would include a classroom for educational sessions (15–20 m²), a designated space in the hospital gym (45–50 m²) with 6–8 exercise machines (treadmills/bicycles), and a single ECG monitor for high-risk patients. The estimated human resource allocation would include a cardiologist for pre- and post-rehabilitation ergometry and exercise prescription, along with a physiotherapist and a nurse who would supervise the sessions 3–4 hours per week. Conclusions Despite resource constraints, planning a cardiac rehabilitation unit in a general hospital is feasible by leveraging ACS admission data and optimizing existing infrastructure and personnel.