Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
The TeleGuard trial of additional telemedicine care in CAD patients. 2 Morbidity and mortality after 12 months
Summary In the TeleGuard trial , 1500 patients with established coronary artery disease ( CAD ) were recruited and r and omized to control or intervention groups . Patients in the intervention group were equipped with a 12-lead event recorder and could contact a call centre and transmit an ECG whenever they wished . In a 12-month study , the composite endpoint ( all-cause mortality , myocardial infa rct ion , re-hospitalization or re-vascularization ) was seen in 40 % of the intervention patients and in 38 % of the control patients . In both groups , approximately 40 % were re-hospitalized . In total , 73 patients experienced re-vascularization , 75 showed an infa rct ion and 33 died . Equipping CAD patients with a 12-lead ECG device and providing a telemedicine centre with 24-hour availability did not decrease risk for the composite endpoint ( re-hospitalization , re-vascularization , ( subsequent ) myocardial infa rct ion and /or death ) . It is likely that the clinical pathway used in the telemedicine centre led to an increased hospital admission rate in the intervention group
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .