Cardiac Rehabilitation Registries as Tools for Quality Improvement and Research: Insights From the SWEDEHEART-CR registry

Cardiac rehabilitation (CR) is a well established intervention for secondary prevention after myocardial infarction (MI), yet substantial variability in CR delivery and patient outcomes persists globally. This review provides an in-depth overview of the SWEDEHEART-CR registry, a comprehensive Swedish national quality registry that has facilitated continuous quality improvement and clinical research in secondary prevention since its inception in 2005. SWEDEHEART-CR now achieves full national coverage on the centre level, capturing detailed longitudinal data on patient risk factors, psychosocial outcomes, exercise capacity, and adherence to CR components for more than 8500 post-MI patients annually. We discuss how the registry's validated quality index enables benchmarking and ongoing monitoring of care processes, highlighting substantial advances in cardiovascular risk management alongside enduring challenges. Furthermore, we highlight SWEDEHEART-CR's role as a pioneering platform for registry-based randomised controlled trials, enabling pragmatic evaluations of novel rehabilitation interventions such as tele-rehabilitation. The review also addresses ongoing large-scale studies that use the registry to investigate physical activity patterns after MI and how to implement optimal CR processes and structures in everyday clinical care. Finally, we explore future opportunities for international collaboration through harmonised CR registries to advance quality improvement and embedded clinical research on a broader scale. The SWEDEHEART-CR registry exemplifies how high-quality registry data can enhance equitable, evidence-based delivery of care and inform clinical practice and policy to improve cardiovascular outcomes.