The review pooled 107 randomised trials of exercise-based cardiac rehabilitation against a no-exercise control in 26,886 adults with coronary heart disease, most of them after infarction or revascularisation, with follow-up of at least six months. Twenty-two trials with 3,456 participants are new since the previous version, and outcomes are stratified by short, medium and long follow-up, with GRADE certainty assessed at 6 to 12 months. At 6 to 12 months it reduced myocardial infarction (RR 0.72, 95% CI 0.54 to 0.95, high certainty), likely reduced all-cause hospital admission (RR 0.65, 0.51 to 0.82) and all-cause mortality (RR 0.86, 0.74 to 1.00), may reduce cardiovascular mortality (RR 0.87, 0.68 to 1.11), and made little to no difference to bypass grafting (RR 1.00, 0.78 to 1.28).
Why it is interesting: The largest randomised evidence base on a secondary-prevention intervention delivered at scale, updated with a 2026 search.