Current status of cardiac rehabilitation in Latin America and the Caribbean.
BACKGROUND
The prevalence of coronary artery disease (CAD) in Latin America is increasing and contributes importantly to the global burden of cardiovascular diseases. Advanced resources for the diagnosis and treatment of CAD are available in most of the region. However, preventive approaches such as cardiovascular rehabilitation programs (CVRP) may not be widely implemented.


METHODS
We carried out a telephone-based survey to hospitals sampled in a random and population-weighted fashion from a list of 202 centers with cardiac catheterization laboratories in Mexico, Central and South America, and the Caribbean. We collected information of availability of cardiac procedures and imaging techniques and also extensive data about the presence, characteristics, and quality measures of CVRP.


RESULTS
A total of 98 centers were contacted, and a complete survey was provided by 59 centers (60%) from 13 countries. Cardiovascular rehabilitation programs were available in only 56% of centers. There were no differences between centers with and without CVRP regarding type of hospital, availability of cardiac surgery, and annual volume of patients with myocardial infarction. Among centers with CVRP, 70% offered all phases of CVRP. The lack of CVRP was attributed to lack of qualified personnel in 41% of centers, financial constraints in 33%, and lack of physical space in 13%. All centers without CVRP performed cardiac surgery and percutaneous interventions.


CONCLUSIONS
Despite the presence of state-of-the-art technology for the diagnosis and treatment of CAD, availability of CVRP, a less expensive yet effective tool for the treatment of CAD, appears to be limited in Latin America and the Caribbean.
Korenfeld
Yoel
Y
Cardiovascular Division, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Mendoza-Bastidas
Carlos
C
Saavedra
Leonardo
L
Montero-Gómez
Aura
A
Perez-Terzic
Carmen
C
Thomas
Randal J
RJ
Sert-Kuniyoshi
Fatima
F
Vallejos
Julio
J
Ibañez-Arenas
Rodrigo
R
Lopez-Jimenez
Francisco
F
D000072038:Cardiac Rehabilitation; D017691:Caribbean Region; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*