KAROLA is an observational, prospective cohort study in which 1,206 patients with coronary heart disease (CHD) aged 30-70 years participating in an in-hospital rehabilitation program between January 1999 and May 2000 in two co-operating clinics (Schwabenland-Klinik, Isny and Klinik am Südpark, Bad Nauheim, Germany) were enrolled. Only patients who were admitted within 3 months after their first acute event or coronary artery revascularization were included. Baseline data included detailed information from medical records, medical exams and patient questionnaires. An active follow-up has been conducted 1, 3 and 4.5, 6, 8, 10 and 13 years later (33, 34). Beside life style factors, quality of life and other patient reported information obtained by contacting the patient, the occurrence of secondary cardiovascular disease events was evaluated by contacting the primary care physicians. If a subject died during follow-up, the death certificate was obtained from local Public Health departments and the main cause of death was coded according to the International Classification of Diseases. Follow-up is ongoing.