Clinician and Patient Perspectives on Cardiac Rehabilitation for Type 1 vs Type 2 Myocardial Infarction.

BACKGROUND: Cardiac rehabilitation (CR) is recommended after myocardial infarction (MI), but perceptions of its role after type 2 MI remain unclear. OBJECTIVES: The aim of the study is to assess clinician and patient perceptions of CR benefits and safety after type 2 MI, clinician-reported referral frequency, and the willingness of patients to participate. METHODS: In this cross-sectional study, 118 clinicians from 2,250 invitations across Mass General Brigham completed a survey comparing perceptions of CR after type 1 vs type 2 MI. Fifty type 2 MI inpatients at a single academic center completed a survey assessing perceptions of CR. RESULTS: Among 110 clinicians with complete paired responses, fewer self-reported "always" or "often" referring patients after type 2 MI vs type 1 MI (30.0% vs 80.0%; paired difference: -50.0 percentage points; 95% CI: -59.4 to -40.2; P < 0.001), and fewer perceived CR as beneficial (69.1% vs 98.2%; paired difference: -29.1 percentage points; 95% CI: -38.2 to -21.4; P < 0.001). Most clinicians perceived CR as safe although slightly fewer rated it as safe after type 2 MI (92.7% vs 99.1%; paired difference: -6.4 percentage points; 95% CI: -12.6 to -2.8; P = 0.02). Among patients with type 2 MI, 90% perceived CR as beneficial, 80% believed CR would improve safety returning to activity, and 82% would likely attend if referred. CONCLUSIONS: Clinicians self-reported lower CR referral frequency after type 2 MI than after type 1 MI, with lower perceived benefit and barriers related to CR eligibility and referral process familiarity. Most patients with type 2 MI perceive CR as beneficial and report hypothetical willingness to participate if referred.