Curriculum in CardiologyEfficacy of exercise-based cardiac rehabilitation post–myocardial infarction: A systematic review and meta-analysis of randomized controlled trials
Section snippets
Methods
We carried out this systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.8
Search results
Our search strategy identified 2,169 potentially relevant articles of which 369 were reviewed as abstracts and 147 as full articles (Figure 1). Thirty-four RCTs were included in the final analysis.10, 11,15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52 One study reported 15-year follow-up data27; these protracted follow-up data were not included, as they represented an outlier, and instead,
Discussion
Our study was designed to examine the therapeutic effects of exercise-based CR as secondary prevention post-MI. Our primary analysis focused on establishing the overall benefit of exercise-based CR. Our results demonstrate a statistically significant reduction in reinfarction, cardiac mortality, cardiovascular mortality, and all-cause mortality with exercise-based CR. To our knowledge, this is the first meta-analysis to show a statistically significant reduction in reinfarction with
Conclusion
Exercise-based CR reduces the risk of reinfarction and cardiac, cardiovascular, and all-cause mortality when used as secondary prevention post-MI. Even if more modest benefits are obtained when CR is used in everyday current practice, our results suggest that exercise-based CR is efficacious for secondary prevention. Our examination of RCT-level characteristics suggests that even short-term CR programs post-MI could be of benefit and that the overall observed benefits persisted beyond the
Disclosures
The authors declare no conflict of interest.
Acknowledgements
We would like to thank Tara Dourian for her help with data abstraction.
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Dr Eisenberg is a National Researcher of the Quebec Foundation for Health Research.