Author + information
- Robert R. West, MA, PhD, FSS, FFPHM⁎ ()
- ↵⁎Wales Heart Research Institute, Heath Park, Cardiff, CF14 4XN Wales, United Kingdom
In an observational study Witt et al. (1) report a striking survival advantage among patients attending cardiac rehabilitation. They employ a rather unusual adjustment to compare patients of very different ages, a “propensity to attend cardiac rehabilitation” rather than the more usual inclusion of prognostic risk factors in multivariate analyses.
Their findings are not borne out by randomized trials. In discussion, they comment that early (small) trials may not be generalized to contemporary practice. Too true. Pooling of all trials undertaken since the World Health Organization European collaborative (but excluding ours, see the next sentence) show collectively no significant effect on mortality (2). The only multicenter trial undertaken since widespread use of thrombolysis, aspirin, beta-blocker, angiotensin-converting enzyme inhibitor, and statin shows no effect on mortality (3).
- American College of Cardiology Foundation
- Witt B.J.,
- Jacobsen S.J.,
- Weston S.A.,
- et al.
- West R.R.,
- Beswick A.D.