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‘FIT FOR PURPOSE’. The COACH program improves lifestyle and biomedical cardiac risk factors
  1. Michael V Jelinek1,2,
  2. John D Santamaria1,2,
  3. David R Thompson3,
  4. Margarite J Vale2,4
  1. 1St Vincent's Hospital, Melbourne, Australia
  2. 2Department of Medicine, University of Melbourne, Melbourne, Australia
  3. 3Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia
  4. 4The COACH Program, Managing Director of the COACH Program, University of Melbourne, Melbourne, Australia
  1. Correspondence to Dr Michael V Jelinek, 55 Victoria Parade, Fitzroy, Victoria 3065, Australia; jelinem{at}

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The ‘Rehabilitation after Myocardial Infarction Trial’ (RAMIT) showed that cardiac rehabilitation in the UK failed to impact on total mortality, cardiac morbidity, health related quality of life and behavioural risk factors.1 These results were met with indignation. David Wood actually questioned whether cardiac rehabilitation as performed in the UK was ‘fit for purpose’.2 Which raises the question: what is the purpose of cardiac rehabilitation? We believe that the immediate objectives of cardiac rehabilitation are to improve the physical fitness of cardiac patients after acute illness or cardiac procedures and to initiate secondary prevention by improving lifestyle and biomedical risk factors. Nowadays, patients spend 2–4 days in hospital after an acute coronary syndrome. They are not deconditioned. They are fit to return to work 2–4 weeks after the acute event. They are unlikely to attend a cardiac rehabilitation …

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