Cardiac Rehabilitation

C ardiac rehabilitation (CR) is a multidisciplinary, second- ary prevention treatment modality 1 that reduces mortality and morbidity among patients with coronary heart disease and improves symptoms, functional capacity, metabolic status, depression, and health-related quality of life. 2,3 A recent analysis suggested that CR contributed significantly to the reduction in coronary heart disease mortality observed in the United States between 1980 and 2000 and that the risk reduction attributable to CR was comparable to reductions attributed to postevent aspirin, -blocker, angiotensinconverting enzyme inhibitor, statin, and warfarin therapy as well as to risk reductions attributed to acute thrombolysis and revascularization. CR is considered a Class I indication after acute coronary syndrome, coronary revascularization, and for stable angina, but remains underutilized with low referral, low enrollment, and low completion rates and considerable disparities in access.