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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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  • All authors had access to the data and were involved in the writing of the manuscript. This manuscript is submitted as an original paper.

  • Contributors MVJ designed this project, helped with data analysis and the writing of this letter. JDS performed the statistical analysis of the data and contributed to the writing of the letter. DT contributed to the writing of the letter. MJV is the founder and managing director of The COACH Program.

  • Funding This data is self-funded. This work was funded by the COACH Program.

  • Competing interests MVJelinek is honorary medical advisor to The COACH Program; MJV is the Director of The COACH Program which is self-funding; JDS and MT have no financial interests in The COACH Program.

  • Provenance and peer review Not commissioned; internally peer reviewed.