A Cochrane review included 23 studies with a total of 2 890 subjects undergoing cardiac rehabilitation following an acute myocardial infarction (MI) or revascularisation, or with heart failure. No difference was seen between home- and centre-based cardiac rehabilitation in outcomes up to 12 months of follow up in mortality (RR 1.19, 95% CI 0.65 to 2.16), cardiac events, exercise capacity (SMD -0.13, 95% CI -0.28 to 0.02) or health-related quality of life. Trials were generally of short duration, with only three studies reporting outcomes beyond 12 months (exercise capacity: SMD 0.11, 95% CI -0.01 to 0.23; participants = 1074; studies = 3; moderate quality evidence). However, there was evidence of marginally higher levels of programme completion (RR 1.04, 95% CI 1.00 to 1.08; participants = 2615; studies = 22/comparisons = 26; low quality evidence) by home-based participants.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and blinding) and by inconsistency (unexplained variability in results).