APCU25OS4 Integrating cardiac rehabilitation into secondary prevention pathways: real-world experience from Malaysia

Introduction Cardiovascular disease continues to place a heavy burden on healthcare systems in Southeast Asia. Cardiac rehabilitation (CR), recommended as a Class I intervention for secondary prevention after acute coronary syndrome (ACS), improves survival, functional capacity, and quality of life. Yet, uptake remains low in many low- and middle-income countries due to limited awareness and infrastructure. This study reports on the real-world impact of CR in Malaysia, highlighting its role as a scalable strategy to optimize outcomes across both surgical and non-surgical ACS patients.Methods We retrospectively analysed 500 patients completing eight CR sessions at Hospital Pulau Pinang between 2023 and 2025. Patients were grouped into coronary artery bypass grafting (CABG) and non-CABG categories. Clinical outcomes assessed included blood pressure, body mass index (BMI), lipid and glucose levels, smoking behaviour, and exercise tolerance. Statistical analysis employed one-way ANOVA, Kruskal-Wallis, and Chi-square tests.Results Both CABG and non-CABG patients demonstrated significant improvements in cardiovascular risk factors. CABG patients achieved greater reductions in blood pressure (30% to 72% in 2023; 48% to 92% in 2025), BMI normalization (32% to 70% in 2023; 44% to 96% in 2025), and higher smoking cessation rates compared to non-CABG patients. Nonetheless, the non- CABG group also recorded meaningful improvements across all parameters, underscoring CR’s broad applicability.Discussion This study reinforces the importance of embedding CR as a routine element of post-ACS care. The stronger outcomes among CABG patients may reflect heightened motivation after major surgery, but the consistent benefits across groups highlight CR’s universal value. The Malaysian experience demonstrates that structured CR programs can be effectively delivered within public healthcare, serving as a model for scaling secondary prevention in the region.