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Abstract 11878: Physiologic Changes Induced by Cardiac Rehabilitation in Post Myocardial Infarction Patients: A Systematic Review and Meta-analysis

Irene Kirolos, F. Péndola, Omar Picado-Roque, S. Andrade-Bucknor, S. Chaparro, C. Alfonso, Mauricio G. Cohen

Circulation, 2016

1,683 participants

Abstract

Introduction:

A meta-analysis to evaluate the physiologic changes associated with Cardiac Rehabilitation (CR) in post myocardial infarction (MI) patients was conducted.

Hypothesis:

CR is a non-pharmacological intervention associated with improved outcomes after MI

Methods:

We performed an online database search of PubMed, MEDLINE, EMBASE, SCOPUS, COCHRANE, and GOOGLE SCHOLAR (1988 - Present); and reviewed key bibliographies. Studies comparing post MI patients according to CR referral were included. Relative risks with the corresponding 95% confidence intervals (CI) by random effects models of pooled data were calculated. Study quality was assessed using STROBE criteria. Outcomes of interest measured after conclusion of CR, these included resting and maximum heart rate (HR), Peak VO2, ejection fraction (EF), wall motion score index (WMSI), left ventricular end diastolic diameter (LVEDD)

Results:

Of 147 studies searched, 23 studies met our selection criteria, 19 of which were randomized clinical trials, including 1683 patients (827 referred to CR vs 855 not enrolled in CR). Median age was 58 years. There were no significant difference between the two groups in terms of age, comorbidities, severity, baseline EF or HR. CR patients had significantly lower post-exercise resting HR (RR:-0.72, CI:-0.87 to -0.56; p<0.05), higher EF (RR:0.14, CI:0.04-0.25, p<0.05), lower LVEDD (RR: -0.31, CI:-059,-0.02;p <0.05), lower WMSI (RR:-0.33, CI:-0.62, -0.05; p<0.05), and higher peak VO2…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,683 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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