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Meta-Analysis
. 2019 Jul 7:25:5015-5027.
doi: 10.12659/MSM.917362.

Effects of Exercise-Based Cardiac Rehabilitation in Patients with Acute Coronary Syndrome: A Meta-Analysis

Haigang Ji  1 , Liang Fang  2 , Ling Yuan  2 , Qi Zhang  2
Affiliations
Meta-Analysis

Effects of Exercise-Based Cardiac Rehabilitation in Patients with Acute Coronary Syndrome: A Meta-Analysis

Haigang Ji et al. Med Sci Monit. .

Abstract

BACKGROUND Acute coronary syndrome (ACS) has become an important cause of death from cardiovascular disease. Cardiac rehabilitation (CR) plays an essential role in ACS patients after treatment. Therefore, in order to detect the impact of CR on mortality and major adverse cardiac events in patients with ACS, we conducted this meta-analysis. MATERIAL AND METHODS We searched PubMed, Web of science, and EMBASE databases to obtain published research results from 2010 to August 2018 to determine the relevant research. Random-effects model or fixed-effects model were used to calculate relative risk (RR) and 95% confidence interval (CI). RESULTS Overall, a total of 25 studies with 55 035 participants were summarized in our meta-analysis. The results indicated that the hazard ratio (HR) of mortality significantly lower in the CR group than in the non-CR group (HR=-0.47; 95% CI=(-0.56 to -0.39; P<0.05). Fourteen studies on mortality rate showed exercise was associated with reduced cardiac death rates (RR=0.40; 95% CI=0.30 to 0.53; P<0.05). We found the risk of major adverse cardiac events (MACE) was lower in the rehabilitation group (RR=0.49; 95% CI=0.44 to 0.55; P<0.05). In 11 articles on CR including 8098 participants, the benefit in the CR group was greater than in the control group concerning revascularization (RR=0.69, 95% CI: 0.53 to 0.88; P=0.003). The recurrence rate of MI was reported in 13 studies, and the risk was lower in the CR group (RR=0.63, 95% CI: 0.57-0.70; P<0.05). CONCLUSIONS Our meta-analysis results suggest that CR is clearly associated with reductions in cardiac mortality, recurrence of MI, repeated PCI, CABG, and restenosis.

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Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
Results of the studies search.
Figure 2
Figure 2
Meta-analysis for the association between CR and HR of cardiovascular mortality.
Figure 3
Figure 3
Meta-analysis for the association between CR and cardiac death rates.
Figure 4
Figure 4
Subgroup meta-analysis based on follow-up time between CR and cardiac death rates.
Figure 5
Figure 5
Meta-analysis for the association between CR and MACE.
Figure 6
Figure 6
Meta-analysis for the association between CR and revascularization.
Figure 7
Figure 7
Subgroup meta-analysis based on treatment before CR between CR and revascularization.
Figure 8
Figure 8
Meta-analysis for the association between CR and non-fatal myocardial infarction.
Figure 9
Figure 9
Funnel plot for the meta-analysis ((A) HR of cardiovascular mortality; (B) cardiac death rates; (C) MACE; (D) revascularization; (E) non-fatal myocardial infarction).
Figure 10
Figure 10
Sensitivity analysis results ((A) cardiac death rates; (B) revascularization).
See this image and copyright information in PMC

References

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