{ "release_id": "5dcd9b263fe17744", "id": "cardio:cardiac-rehabilitation", "owner": "cardio", "kind": "intervention", "slug": "cardiac-rehabilitation", "name": "Cardiac rehabilitation", "aliases": [ "Exercise-based cardiac rehabilitation" ], "atlases": [ "cardio" ], "summary_plain": "A medically supervised program for people with heart disease or after a heart event or heart procedure. MedlinePlus says a team of specialists builds a plan that includes exercise training, education on heart healthy living and counseling to reduce stress, with the aims of returning to an active life and lowering the chance of further heart problems. It is offered after a heart attack, angioplasty or bypass surgery for coronary heart disease, valve repair or replacement, heart or lung transplant, angina and heart failure. An updated Cochrane review of 85 trials in people with coronary heart disease found fewer heart attacks and fewer hospital admissions at 6 to 12 months compared with no exercise, likely little or no difference for some other outcomes, and uncertain effects for others. Many eligible people never take part (see the participation page).", "summary_technical": "Subtype rehabilitation. MeSH Cardiac Rehabilitation (D000072038) is an exact match. The evidence recorded here is the Cochrane review of exercise-based cardiac rehabilitation for coronary heart disease (85 trials, 23,430 participants; the review compared exercise training alone, or combined with psychosocial or educational interventions, with no exercise), split into four claims by GRADE certainty and follow-up, and the MedlinePlus description of who is offered it and what it includes. A joint scientific statement from rehabilitation and cardiology societies describes it as using patient education, health behavior modification and exercise training to improve secondary prevention outcomes, and as significantly underused in the United States. The Cochrane review covers coronary heart disease only. A heart failure trial of a supervised exercise training program is recorded separately; its registry record and abstract do not call that program cardiac rehabilitation, so this record does not link the trial to it.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": null, "identifiers": [ { "scheme": "mesh", "value": "D000072038", "normalized_value": "D000072038", "match": "exact", "version": "read 2026-10-15", "label": null, "from_source": false } ], "navigation": { "cardio": { "system": [ "heart" ], "condition-area": [ "acute-care-and-long-term-living", "coronary-and-vascular-disease" ] } }, "payload": { "subtype": "rehabilitation", "mechanism": "Exercise training with education on heart healthy living and counseling to reduce stress, planned by a team of specialists (MedlinePlus).", "components": null }, "content_digest": "225622fc85b5b47a8eb54fb5e4bb7dc536ef4409052f6baeecdee39db82c34f5", "review": { "content_digest": "225622fc85b5b47a8eb54fb5e4bb7dc536ef4409052f6baeecdee39db82c34f5", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-cochrane-cr-cv-hospitalisation-short-term", "owner": "cardio", "subject_entity_id": "cardio:cardiac-rehabilitation", "category": "effect", "statement": "The Cochrane review is uncertain about the effect of exercise-based cardiac rehabilitation on cardiovascular hospitalisation at 6 to 12 months: the risk ratio was 0.80 (95% CI 0.41 to 1.59), with a wide interval that includes considerable benefit as well as harm, rated low certainty. The abstract also reports substantial heterogeneity across trials for cardiovascular hospitalisations (I2 = 53%).", "context": { "id": "cardio:ctx-cochrane-cr-adults-chd", "label": "Adults with coronary heart disease in randomised trials of exercise-based cardiac rehabilitation (Cochrane review)", "recipient": "adult", "population": "Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.", "care_setting": "Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.", "geography": "Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.", "life_stage_note": "Adults; the mean age across the included trials ranged from 47 to 77 years", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).", "eligibility": { "inclusion": [ "Randomised controlled trials of exercise-based interventions with at least six months of follow-up, compared with a no-exercise control", "Adult men and women who have had a myocardial infarction, coronary artery bypass graft or percutaneous coronary intervention, or have angina pectoris or coronary artery disease" ], "exclusion": [] } }, "evidence_stage": "synthesis", "certainty": "low", "certainty_method": "GRADE assessment by the review authors, stated in the Cochrane review abstract for the primary outcomes at 6 to 12 months", "limitations": "Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. This is a result the review itself calls uncertain, so it does not show that the programmes help or harm on this outcome.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, DATA COLLECTION AND ANALYSIS, sentence 13, fragments 1 and 2", "applicability_note": "Cardiovascular hospitalisation result and its certainty.", "snapshot": { "id": "cardio:pubmed-34741536-2026-10-15", "retrieved_at": "2026-10-15T13:48:11Z", "content_hash": "c88744581358fff0e64fe1548ede864d301df2dc54ea65eb2ade91911c46ecb8", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1002-14651858-cd001800-pub4", "source_type": "publication", "title": "Exercise-based cardiac rehabilitation for coronary heart disease", "canonical_url": "https://doi.org/10.1002/14651858.CD001800.pub4", "identifiers": [ { "scheme": "doi", "value": "10.1002/14651858.CD001800.pub4", "normalized_value": "10.1002/14651858.cd001800.pub4", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "34741536", "normalized_value": "34741536", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC8571912", "normalized_value": "PMC8571912", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2021-11-06", "publisher": "The Cochrane database of systematic reviews", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. 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The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } } ], "review": { "content_digest": "a45699fc74f8c3bb7b452d74e97910665fb027f992175321c4088c6a42c1a0dd", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-cochrane-cr-cv-hospitalisation-short-term.json" }, { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-cochrane-cr-longer-term", "owner": "cardio", "subject_entity_id": "cardio:cardiac-rehabilitation", "category": "effect", "statement": "The Cochrane review also reports longer follow-up results. At medium-term follow-up (more than 12 to 36 months) there may be little to no difference in all-cause mortality (risk ratio 0.90, 95% CI 0.80 to 1.02; 15 trials), myocardial infarction (1.07, 0.91 to 1.27; 12 trials), percutaneous coronary intervention (0.96, 0.69 to 1.35; 6 trials), coronary artery bypass graft (0.97, 0.77 to 1.23; 9 trials) and all-cause hospitalisation (0.92, 0.82 to 1.03; 9 trials), but a large reduction in cardiovascular mortality was found (0.77, 0.63 to 0.93; 5 trials); the evidence is uncertain for cardiovascular hospitalisation (0.92, 0.76 to 1.12; 3 trials). At long-term follow-up (more than 3 years) there may be little to no difference in all-cause mortality (0.91, 0.75 to 1.10), while exercise-based cardiac rehabilitation may result in a large reduction in cardiovascular mortality (0.58, 0.43 to 0.78; 8 trials) and myocardial infarction (0.67, 0.50 to 0.90; 10 trials); the evidence is uncertain for coronary artery bypass graft (0.66, 0.34 to 1.27; 4 trials) and percutaneous coronary intervention (0.76, 0.48 to 1.20; 3 trials). Each value is a risk ratio with its 95% confidence interval.", "context": { "id": "cardio:ctx-cochrane-cr-adults-chd", "label": "Adults with coronary heart disease in randomised trials of exercise-based cardiac rehabilitation (Cochrane review)", "recipient": "adult", "population": "Adult men and women who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris or coronary artery disease, in trials that compared exercise-based cardiac rehabilitation with a no-exercise control. The 85 trials included predominantly post-MI and post-revascularisation patients.", "care_setting": "Randomised trials of exercise-based cardiac rehabilitation, with exercise training alone or combined with psychosocial or educational interventions. The abstract does not describe the settings of the individual trials.", "geography": "Trials from many countries; the abstract says 21 of the 85 trials were done in low- and middle-income countries.", "life_stage_note": "Adults; the mean age across the included trials ranged from 47 to 77 years", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "The review split results into short-term (6 to 12 months), medium-term (more than 12 to 36 months) and long-term (more than 3 years) follow-up. The median longest follow-up was 12 months (range 6 months to 19 years).", "eligibility": { "inclusion": [ "Randomised controlled trials of exercise-based interventions with at least six months of follow-up, compared with a no-exercise control", "Adult men and women who have had a myocardial infarction, coronary artery bypass graft or percutaneous coronary intervention, or have angina pectoris or coronary artery disease" ], "exclusion": [] } }, "evidence_stage": "synthesis", "certainty": "not_assessed", "certainty_method": null, "limitations": "Adults with coronary heart disease in trials of exercise-based cardiac rehabilitation (exercise training alone or with psychosocial or educational interventions) against a no-exercise control. The trials were predominantly post-MI and post-revascularisation patients, and women were under 15% of participants overall. Trial reporting was poor overall, although the abstract says reporting quality improved over the last decade. Only the PubMed abstract was read; the PMC copy is not in the open-access subset. The review used GRADE only for the primary outcomes at 6 to 12 months, so these medium- and long-term results carry no certainty rating in the abstract. The abstract gives the number of trials behind each result.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, DATA COLLECTION AND ANALYSIS, sentences 15 and 16", "applicability_note": "Medium-term results.", "snapshot": { "id": "cardio:pubmed-34741536-2026-10-15", "retrieved_at": "2026-10-15T13:48:11Z", "content_hash": "c88744581358fff0e64fe1548ede864d301df2dc54ea65eb2ade91911c46ecb8", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1002-14651858-cd001800-pub4", "source_type": "publication", "title": "Exercise-based cardiac rehabilitation for coronary heart disease", "canonical_url": "https://doi.org/10.1002/14651858.CD001800.pub4", "identifiers": [ { "scheme": "doi", "value": "10.1002/14651858.CD001800.pub4", "normalized_value": "10.1002/14651858.cd001800.pub4", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "34741536", "normalized_value": "34741536", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC8571912", "normalized_value": "PMC8571912", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2021-11-06", "publisher": "The Cochrane database of systematic reviews", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. 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