CHD is the leading cause of death worldwide. As more people are surviving the disease, long-term management for the same is essential. Out of the several strategies, Cardiac Rehabilitation (CR) is classified as a Class I, Grade A therapy for CHD. While there is ample evidence proving the clinical effectiveness of CR in the treatment of CHD, certain gaps remain in the available research. These gaps include uncertain effect on mortality,  limited data on health-related quality of life, a small set of patients only consisting of low-risk patients in high-income settings, and a lack of data after modern treatment strategies.

To fill in these research gaps, a systematic review and meta-analysis of 85 RCTs was conducted, which included 23,430 participants with a median follow-up of 12 years. The study, conducted between June 2014 and September 2022, is published in the European Heart Journal. The data were sourced from a large pool consisting of CENTRAL, MEDLINE, Embase, CINAHL, Science Citation Index Expanded, WHO Clinical Trials Registry Platform,  ClinicalTrials.gov, and other hand-searched material. The quality of the data was in line with the Cochrane Handbook, PRISMA guidelines, and Synthesis Without Meta-analysis (SWiM) reporting

The outcomes assessed were overall and cardiovascular mortality, myocardial infarction, coronary revascularization (CABG or PCI), all-cause and cardiovascular hospitalization, health-related quality of life, and cost-effectiveness. It was found that exercise-based CR reduced the overall mortality by 15% and cardiovascular mortality by 21%. Apart from this, significant reductions were found in myocardial infarction and all-cause hospitalization. Health-related quality of life was improved, with significant improvements in six of eight SF-36 domains and in EQ-5D VAS scores. 

The study successfully confirms the efficacy of exercise based CR in management of CHD patients.