Summary of findings table
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with usual care | Risk with exercise-based CR | ||||
| All-cause mortality Follow-up: 12 months | 20 per 1000 | 21 per 1000 (4 to 116) | RR 1.01 (0.18 to 5.67) | 195 (3 RCTs) | ⨁◯◯◯ Very low*†‡ |
| AMI Follow-up: 12 months | 39 per 1000 | 13 per 1000 (3 to 64) | RR 0.33 (0.07 to 1.63) | 254 (3 RCTs) | ⨁◯◯◯ Very low†‡§ |
| Exercise capacity assessed using a variety of outcomes including VO2 max and duration of exercise Follow-up: range 6 months to 12 months | The mean exercise capacity in the intervention groups was 0.45 SD higher(0.2 higher to 0.7 higher) | – | 267 (5 RCTs) | ⨁⨁◯◯ Low¶** | |
| Cardiovascular hospital admissions assessed with: Combined clinical endpoint (cardiac death, stroke, CABG, PCI, AMI, worsening angina with objective evidence resulting in hospitalisation) Follow-up: 12 months | Risk with usual care 140 per 1000 Risk with exercise-based CR 20 per 1000 (2–154) | RR 0.14 (0.02 to 1.1) | 101 (1 RCT) | ⨁◯◯◯ Very low†††‡‡ | |
| HRQoL assessed with: Seattle angina questionnaire and The MacNew questionnaire Follow-up: range 6 weeks to 6 months | One study showed improvement in emotional score at 6 week follow-up, and benefits in angina frequency and social HRQoL score at 6 months follow-up | Not estimable | 94 (1 RCT) | ⨁◯◯◯ VERY LOW§§‡‡ | |
| Return to work | No studies were found that looked at return to work. | – | – | – | |
| Adverse events Follow-up: 12 months For example, skeletomuscular injury | Only one study looked at adverse events and reported that there were no adverse events during the exercise-based CR. | Not estimable | 101 (1 RCTs) | ⨁◯◯◯ Very low †††‡‡ | |
* The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
*Some concerns with random sequence generation, allocation concealment, blinding of outcome assessment and selective reporting; bias likely, therefore quality of evidence downgraded by one level.
†Some concern with applicability to review question as participants in all studies were limited to middle-aged men, therefore quality of evidence downgraded by one level.
‡Imprecise due to small number of participants (less than 300) and CIs including potential for important harm or benefit as 95% CI crosses RR of 0.75 and 1.25, therefore quality of evidence downgraded by two levels.
§Some concern with random sequence generation, allocation concealment, blinding of outcome assessment, high loss to follow-up, selective reporting and unbalanced groups at baseline; serious bias likely, therefore quality of evidence downgraded by two levels.
¶Some concern with random sequence generation, allocation concealment, blinding of outcome assessment, selective reporting and unbalanced groups at baseline; bias likely, therefore quality of evidence downgraded by one level.
**Imprecise due to small number of participants (less than 300), therefore quality of evidence downgraded by one level.
††Some concerns with random sequence generation, allocation concealment and selective reporting; bias likely, therefore quality of evidence downgraded by one level.
‡‡Imprecise due to very small number of participants therefore quality of evidence downgraded by two levels.
§§Some concerns with blinding of outcome assessment, selective reporting and groups not receiving comparable care; bias likely, therefore quality of evidence downgraded by one level.
AMI, acute myocardial infarction; CABG, coronary artery bypass graft; CR, cardiac rehabilitation; GRADE, Grading of Recommendations Assessment, Development and Evaluation; HRQoL, health-related quality of life; PCI, percutaneous coronary intervention; RCT, randomised controlled trial.