Provision of exercise-based cardiac rehabilitation (CR) provided important health benefits, including reductions in cardiovascular mortality and hospitalization, and improvements in health-related quality of life. This according to a meta-analysis of 14,486 patients with established coronary heart disease (CHD). After median follow-up of 12 months, researchers found:

• CR led to a reduction in cardiovascular mortality (RR=0.74) and the risk of hospital admissions (RR=0.82).

• There was no significant effect on total mortality, myocardial infarction, or revascularization.

• Most studies showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects.

Citation: Anderson L, Oldridge N, Thompson DR, et al. Exercise-based cardiac rehabilitation for coronary heart disease. J Am Coll Cardiol 2016;67(1):1-12. doi:10.1016/j.jacc.2015.10.044

Commentary: This study further reaffirms that an important part of the comprehensive management of patients with CHD is the provision of CR. In previous meta-analyses, CR showed an improvement in total mortality. The lack of improvement in total mortality in this meta-analysis may be due to the fact that it included newer studies conducted in an era where most patients are receiving optimal medical management, including an antiplatelet agent, beta-blockers, ACS inhibitors and a statin. It may be difficult to show further mortality reduction in optimally managed patients. The outcomes in this study showing reduction in CV mortality and improvement in health-related quality of life are rock-solid and support offering CR to patients with CHD. —Neil Skolnik, MD