Poor rates of referral to cardiac rehabilitation are among the barriers to improving secondary prevention of cardiovascular disease, a report says.

The report, No Second Chances, from the Baker Heart and Diabetes Institute in Melbourne, argues that investment in secondary prevention is the most cost-effective way to tackle the disease, which has changed from being acute and fatal, to chronic and debilitating.

Striking preliminary data from a Queensland cardiovascular registry shows that, after a first myocardial infarction, 39% of patients are readmitted to hospital within three months and 57% within a year, the report says.

It calls for a commitment to four changes, including improving funding and uptake of cardiac rehabilitation.