The review question was defined for the study design, intervention, and outcome. The inclusion criteria for participants were not explicitly described. The restriction to one database in the search strategy and the absence of detail on attempts to minimise language and publication biases means that studies may have been missed. The authors did not report the review process for the selection of studies or data extraction, so the potential for error and bias could not be ruled out.
The quality of included trials was not reported, so the reliability of individual trials and their subsequent synthesis was unclear. It was not clear whether the chosen method of synthesis was appropriate, given that statistical heterogeneity was not reported and study characteristics were not sufficiently detailed to assess clinical variation.
The authors’ conclusion on mortality following acute myocardial infarction reflected the evidence presented, but several methodological limitations in the review means that the reliability of this conclusion is unclear.