Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is high or moderate to high where GRADE has been performed and the intervention is more effective/beneficial than the comparison for key outcomes.
Population: People with coronary heart disease ᵃ
Intervention: Exercise-based cardiac rehabilitation
Comparison: Usual care
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
All‐cause mortality: follow-up 6-12 months ᵇ ᶜ | No statistically significant difference | Moderate |
Cardiovascular mortality: follow-up 6-12 months | No statistically significant difference | Moderate |
Cardiovascular mortality: follow-up >12-36 months and >3 years | Favors intervention | GRADE assessment not performed for this outcome |
Fatal and/or nonfatal myocardial infarction (MI): follow-up 6-12 months | Favors intervention | High |
Fatal and/or nonfatal MI: follow-up >12-36 months | No statistically significant difference | GRADE assessment not performed for this outcome |
Fatal and/or nonfatal MI: follow-up >3 years | Favors intervention | GRADE assessment not performed for this outcome |
Revascularization: Coronary Artery Bypass Graft (CABG): follow-up 6-12 months ᵇ | No statistically significant difference | High |
Revascularization: Percutaneous Coronary Intervention (PCI): follow-up 6-12 months ᵇ | No statistically significant difference | Moderate |
Hospital admissions: follow-up 6-12 months | Favors intervention | Moderate |
Hospital admissions: follow-up >12-36 months | No statistically significant difference | GRADE assessment not performed for this outcome |
Health‐related quality of life (HRQoL) (follow‐up 6-12 months): physical component score ᵈ | No statistically significant difference | GRADE assessment not performed for this outcome |
HRQoL (follow‐up 6 to 12 months): mental component score | Favors intervention | GRADE assessment not performed for this outcome |
Note ᵃ The Cochrane Clinical Answer (CCA) and the Cochrane review it is based upon note that the population consisted mainly of middle-aged men post-MI or revascularization, which may limit the generalizability of results particularly to women and higher risk men (e.g., those with angina pectoris or major comorbidities). ᵇ This outcome was also reported as not statistically significantly different at >12-36 months and >3 years. However, GRADE was not reported for these timepoints. ᶜ The CCA notes that exercise may modestly reduce total mortality at all time points (6-12 months, >12-36 months, and at >3 years) compared with usual care but none of the analyses reached statistical significance. ᵈ The CCA also notes that six RCTs with 1731 participants reported better physical component scores with exercise compared with usual care, although results did not reach statistical significance.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- For people with coronary artery disease, how do transradial and transfemoral approaches to diagnostic coronary angiography and percutaneous coronary intervention (PCI) compare?
- In people with myocardial infarction complicated by cardiogenic shock, what are the effects of intra-aortic balloon pump counterpulsation (IABP)?
- How do drug-eluting stents compare with bare-metal stents for people with acute coronary syndrome?
- What are the effects of exercise‐based cardiac rehabilitation for people with coronary heart disease?
- For people with acute coronary syndrome, how does fondaparinux compare with enoxaparin and unfractionated heparin (UFH)?
- In people with acute myocardial infarction, what are the benefits and harms of stem cell treatment?
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