Methods:

The Japanese Coronary Artery Disease (JCAD) study enrolled patients with coronary artery disease (CAD), defined as ≥75% stenosis in ≥1 of three major coronary arteries. All patients were enrolled in the cohort between April 2000 and March 2001 from 202 hospitals throughout Japan. Patients with missing data on exercise or diet were excluded from the study. Lifestyle interventions were defined based on Japanese national guidelines for diet and physical activity, and dependent on each attending physician’s discretion. Patients were followed every 6 months for 3 years post-enrollment. The primary outcome of interest was all-cause mortality. Secondary outcomes included recurrent cardiovascular events, cerebral events, and vascular events. Recurrent cardiac events were defined as fatal and nonfatal myocardial infarctions, unstable angina, or heart failure requiring medical therapy, percutaneous coronary intervention, or coronary artery bypass graft surgery, resuscitated cardiac arrest, or cardiopulmonary event on arrival. Cerebral events were defined as cerebral hemorrhage, cerebral infarction, or transient ischemic attack. Aortic dissection and rupture of aortic aneurysm were classified as vascular events.