Table 1.
Evidence for cardiac rehabilitation: summary of Cochrane review findings
| Condition reviewed (year) | Details | Mortality | CVD morbidity | Hospitalization | Health-related quality of life | Ref. |
|---|---|---|---|---|---|---|
| Coronary heart disease (2021) | 84 trials; median follow-up 6 months; 23,172 participants, primarily after MI or revascularization |
All-cause: RR 0.87, 95% CI 0.73–1.04 (25 trials; 9,946 participants; good certainty) CVD: RR 0.88, 95% CI 0.68–1.15 (five trials; 5,360 participants; moderate certainty) |
CABG surgery: RR 0.99, 95% CI 0.78–1.27 (20 trials; 4,473 participants; moderate certainty) PCI: RR 0.86, 95% CI 0.63–1.19 (13 trials; 3,465 participants; moderate certainty) Fatal or non-fatal MI: RR 0.72, 95% CI 0.55–0.93 (22 trials; 7,432 participants; moderate certainty) |
All-cause: RR 0.58, 95% CI 0.43–0.77 (14 trials; 2,030 participants; low certainty) CVD-related: RR 0.80, 95% CI 0.41–1.59 (six trials; 1,087 participants; low certainty) |
SF-12/36, PCS: MD 1.23, 95% CI 1.04–3.50 (four trials; 1,104 participants; no GRADE assessment) SF-12/36, MCS: MD 2.33, 95% CI 1.02–3.63 (four trials; 1,104 participants; no GRADE assessment) |
10 |
| Heart failure (2019) | 44 trials; median follow-up 6 months; 5,783 participants, primarily with HFrEF | All-cause: RR 0.89, 95% CI 0.66–1.21 (17 trials; 2,596 participants; low certainty) | NR |
All cause: RR 0.70, 95% CI 0.60–0.83 (20 trials; 2,142 participants; moderate certainty) HF-related: RR 0.59, 95% CI 0.42–0.84 (14 trials; 1,114 participants; low certainty) |
MLwHF: MD –7.1, 95% CI –10.5 to –3.7 (17 trials; 1,995 participants; low certainty) | 15 |
| Atrial fibrillation (2017) | Six trials; follow-up from 8 weeks to 6 months; 421 participants | All-cause: RR 1.00, 95% CI 0.06–15.78 (six trials; 421 participants; very low certainty) | Serious adverse eventsa: RR 1.01, 95% CI 0.98–1.05 (five trials; 381 participants; very low certainty) | NR |
SF-36 physical: MD 1.96, 95% CI –2.50 to 6.42 SF-36 mental: MD 1.99, 95% CI –0.48 to 4.46 (two trials; 224 participants; very low certainty) |
17 |
| Congenital heart disease (2020) | 15 trials, median follow-up not reported; 924 participants | NR | NR | NR | SF-36 total score, MLwHF, EQ5D VAS: SMD 0.76, 95% CI –0.13 to 1.65 (three trials; 163 participants; very low certainty) | 18 |
| Implantable cardioverter–defibrillator (2019) | Eight trials; median follow-up 3 months; 1,730 participants | All cause: RR 1.96, 95% CI 0.18–21.26 (one trial; 196 participants; low certainty) | Serious adverse eventsa: RR 1.05, 95% CI 0.77–1.44 (two trials; 356 participants; low certainty) | NR | NR | 19 |
| Heart transplantation (2017) | 10 trials; median follow-up 3 months; 300 participants | NR | NR | NR | NR | 20 |
| Valve surgery (2020) | Six trials; follow-up 3–14 months; 364 participants | All-cause: RR 0.83, 95% CI 0.26–2.68 (two trials; 131 participants; very low certainty) | NR | All-cause: RR 2.72, 95% CI 0.11–65.56 (one trial; 122 participants; very low certainty) |
SF-36 physical: MD –0.87, 95% CI –3.57 to 1.83 SF-36 mental: MD –1.45, 95% CI –4.70 to 1.80 (two trials, 150 participants; very low certainty) |
21 |
All outcomes are pooled outcomes at 6–12 months of follow-up, and quality assessment is based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, unless otherwise stated. CABG, coronary artery bypass graft; CVD, cardiovascular disease; EQ5D VAS, EuroQoL Visual Analogue Scale; HFrEF, heart failure with reduced ejection fraction; MCS, mental component score; MD, mean difference; MI, myocardial infarction; MLwHF, Minnesota Living with Heart Failure questionnaire; NR, not reported; PCI, percutaneous coronary intervention; PCS, physical component score; RR, relative risk; SF, Short-Form; SMD, standardized mean difference. aSerious adverse events defined as any untoward medical occurrence that was life-threatening, resulting in death or that was persistent or leading to substantial disability; any medical event that had jeopardized the patient or required intervention to prevent it; any hospital admission or prolongation of existing hospital admission.