Cardiorespiratory fitness for patients undergoing cardiac rehabilitation is a strong individual predictor of mortality and morbidity. Importantly, an improvement in fitness as small as 4% is known to reduce mortality by 13% and cardiovascular morbidity by 21%. However, the efficacy of cardiac rehabilitation for improving fitness differs with patient ethnicity, psychosocial and physical characteristics. To date, studies exploring this relationship have primarily recruited patients of Western European descent, and so generalisability to diverse ethnicities, like those living in Western Sydney, is entirely unknown.

This study will evaluate the cardiorespiratory fitness for cardiac rehabilitation patients in Western Sydney and any association with subsequent all-cause mortality, cardiovascular mortality and major adverse cardiovascular events. To do this, we will utilise a cohort of >7,500 patients who enrolled in cardiac rehabilitation at Westmead Hospital between 1993 and 2022, who completed an exercise stress test at program admission. This study is unique, as it will be significantly larger (>7,500 patients) and longer (30 years) than any previous cardiac rehabilitation cohort study worldwide to examine the association between fitness and mortality/morbidity outcomes. We hope the findings of this study will create a positive impetus for fitness as a novel and modifiable marker of prognosis within the ethnically-diverse cardiac rehabilitation context in Australia, and help advocate for funding to support the implementation of fitness assessments in across Australian programs.

Dr Matthew Hollings (SOLVE-CHD Research Fellow) was able to secure funding for this project through the NHMRC Centre of Research Excellence for Coronary Artery Disease Catalyst Awards for Seed Funding