Cardiac Rehabilitation Programs for Chronic Heart Disease: A Bayesian Network Meta-analysis
| Autor: | Lihong Jiang, Xingsheng Li, Yu Xu, Hong Zhang, Sanrong Wang, Wenhua Su, Yu Cao, Yang Sun, Suetonia C. Palmer, Giovanni F.M. Strippoli, Ying Wang, ND Melgiri, Liwen Liang, Rongzhong Huang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heart Diseases medicine.medical_treatment Myocardial Infarction MEDLINE 030204 cardiovascular system & hematology law.invention Odds 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans 030212 general & internal medicine Myocardial infarction Cardiac Rehabilitation Rehabilitation business.industry Percutaneous coronary intervention Odds ratio medicine.disease Exercise Therapy Hospitalization Meta-analysis Chronic Disease Emergency medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | Canadian Journal of Cardiology. 37:162-171 |
| ISSN: | 0828-282X |
| Popis: | Background Cardiac rehabilitation is a medically supervised program after coronary events that involves exercise and dietary modification. We evaluated the comparative benefits and harms of cardiac rehabilitation strategies via a network meta-analysis. Methods We followed a pre-specified protocol (PROSPERO: CRD42018094998). We searched Embase, MEDLINE, and Cochrane Central Register of Randomized Trials databases for randomized controlled trials that evaluated cardiac rehabilitation vs a second form of rehabilitation or standard/usual care in adults after myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or angiography. Risk of bias and evidence quality was evaluated using the Cochrane tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. Pairwise and Bayesian network meta-analyses were performed for 11 clinical outcomes. Results We included 134 randomized controlled trials involving 62,322 participants. Compared with standard care, exercise-only cardiac rehabilitation reduced the odds of cardiovascular mortality (odds ratio [OR], 0.70; 95% credibility interval [CrI], 0.51-0.96; moderate-quality evidence), major adverse cardiovascular events (OR, 0.57; 95% CrI, 0.40-0.78; low-quality evidence), nonfatal myocardial infarction (OR, 0.71; 95% CrI, 0.54-0.93; moderate-quality evidence), all-cause hospitalization (OR, 0.74; 95% CrI, 0.54-0.98; moderate-quality evidence), and cardiovascular hospitalization (OR, 0.69; 95% CrI, 0.51-0.88; moderate-quality evidence). Exercise-only cardiac rehabilitation was associated with lower cardiovascular hospitalization risk relative to cardiac rehabilitation without exercise (OR, 0.68; 95% CrI, 0.48-0.97; moderate-quality evidence). Conclusions Cardiac rehabilitation programs containing exercise might provide broader cardiovascular benefits compared with those without exercise. |
| Databáze: | OpenAIRE |
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