Evidence summary (Updated 2022)
A large body of good quality randomised controlled data shows consistent prevention of mortality and hospital admissions(1–3) from cardiac rehabilitation.
However Long et al found evidence in 1 study only showing a reduction in cardiovascular-related hospital admissions (RR 0.14, 95% CI 0.02 to 1.1).(4)
Dibben et al in 2021 published a further Cochrane review (85 trials, n=23,430) looking at exercise-based cardiac rehabilitation and found a small reduction in all-cause mortality (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.73 to 1.04; 25 trials; moderate certainty evidence) in a 6-12 moth follow-up period and found a large reduction in all-cause hospitalisation (RR 0.58, 95% CI 0.43 to 0.77; 14 trials; NNTB 12, 95% CI 9 to 21; moderate certainty evidence). Exercise-based CR likely results in little to no difference in risk of cardiovascular mortality (RR 0.88, 95% CI 0.68 to 1.14; 15 trials; moderate certainty evidence (8)
Quality of evidence
B – Moderate quality
Strength of recommendation
Physical activity has an important role in reducing mortality and hospital admissions and should be part of the management plan of patients living with IHD.
- Belardinelli R, Paolini I, Cianci G, Piva R, Georgiou D, Purcaro A. Exercise training intervention after coronary angioplasty: the ETICA trial. J Am Coll Cardiol. 37:1891–1900.
- Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis. J Am Coll Cardiol. 67:1–12.
- Taylor. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. (ue 7. Art. No: CD001800).
- Long L, Anderson L, Dewhirst AM, He J, Bridges C, Gandhi M, et al. Exercise-based cardiac rehabilitation for adults with stable angina. Cochrane database Syst Rev [Internet]. 2018 Feb 2 [cited 2022 Oct 7];2(2). Available from: https://pubmed.ncbi.nlm.nih.gov/29394453/