Of note, reviewed studies included only patients with CHD (MI event, diagnosis of CAD, CABG, or PCI), most of whom began the exercise intervention between 2 8 weeks after the event. Therefore, the Work Group determined that the beneficial effects supported by the evidence are mostly limited to patients with a recent diagnosis or cardiac event. Safety outcomes were not reported in the body of evidence. Although the evidence base supports a structured cardiac rehabilitation program to lower mortality in patients with CHD, the Work Group would anticipate some variability in patient preference and limitations in feasibility related to resource requirements. The Work Group would anticipate some patients would be more accepting than others of the behavioral changes required to engage in an exercise program; in particular, cardiac rehabilitation programs tend to be of higher intensity. Additionally, the human resource (i.e., physiotherapists) and equipment requirements of many clinic and community-based programs might limit feasibility in some settings. However, the evidence demonstrated similar CV outcomes with home- based programs, which might have fewer fiscal costs and other resource demands compared to their clinic or community-based counterparts. As this is a Reviewed, New-added recommendation, the Work Group systematically reviewed evidence related to this recommendation.[147] The Work Group s confidence in the quality of the evidence was moderate. The body of evidence had some limitations, including significant heterogeneity in exercise interventions and risk of bias in the primary studies. Most of the latter was detection bias because of the inherently problematic nature of blinding in exercise interventions and attrition bias from missing outcomes data. Other considerations regarding this recommendation included the benefits (e.g., improved CV mortality, all-cause mortality, and non-fatal MI). 