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Background  Participation in cardiac rehabilitation ( CR ) after acute myocardial infarction has been proven to significantly reduce morbidity and mortality. Historically, participation rates have been low, and although recent efforts have increased referral rates, current data on  CR  participation are limited.    Methods and Results  Utilizing data from the Behavioral Risk Factor Surveillance System conducted by Centers for Disease Control and Prevention, we performed a population‐based, cross‐sectional analysis of  CR  post‐acute myocardial infarction. Unadjusted participation from 2005 to 2015 was evaluated by univariable logistic regression. Multivariable logistic regression was performed with patient characteristic variables to determine adjusted trends and associations with participation in  CR  in more recent years from 2011 to 2015. Among the 32 792 survey respondents between 2005 and 2015, participation ranged from 35% in 2005 to 39% in 2009 ( P =0.005) and from 38% in 2011 to 32% in 2015 ( P =0.066). Between 2011 and 2015, participants were less likely to be female (odds ratio [ OR ] 0.763, 95% confidence interval [ CI ] 0.646‐0.903), black ( OR  0.700, 95%  CI  0.526‐0.931), uninsured ( OR  0.528, 95%  CI  0.372‐0.751), less educated ( OR  0.471, 95%  CI  0.367‐0.605), current smokers ( OR  0.758, 95%  CI  0.576‐0.999), and were more likely to be retired or self‐employed ( OR  1.393, 95%  CI  1.124‐1.726).    Conclusions  Only one third of patients participate in  CR  following acute myocardial infarction despite the known health benefits. Participants are less likely to be female, black, and uneducated. Future studies should focus on methods to maximize the proportion of  CR  referrals converted into  CR  participation.

journal of the american heart association

Trends and Predictors of Participation in Cardiac Rehabilitation Following Acute Myocardial Infarction: Data From the Behavioral Risk Factor Surveillance System