Key result
Non-pharmacological interventions cut MI risk ~64% and reduce CV readmissions and death post-PCI.
Why the study?
The study was conducted to investigate the impact of non-pharmacological interventions on major adverse cardiac events in patients with coronary artery disease who underwent percutaneous coronary intervention.
Do non-pharmacological interventions reduce major adverse cardiac events in patients who underwent percutaneous coronary intervention?
Meta-Analysis (n=2,898)
Do non-pharmacological interventions reduce major adverse cardiac events in patients who underwent percutaneous coronary intervention?
Effect estimate: OR 0.36 (95% CI 0.18-0.72)
p-value: p=0.004
Non-pharmacological interventions, particularly comprehensive programs and those lasting over 7 months, significantly reduce the incidence of major adverse cardiac events and cardiovascular mortality in patients following percutaneous coronary intervention.
Supports integrating non-pharmacological interventions into post-PCI care; reinforces Level 1 evidence for MACE reduction.
PURPOSE: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). RESULTS: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. CONCLUSION: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).
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Jo et al. (2024) conducted a meta-analysis in Coronary artery disease post-percutaneous coronary intervention (PCI) (n=2,898). Non-pharmacological interventions (education, exercise, and comprehensive) vs. Usual care or sham intervention was evaluated on Myocardial infarction (OR 0.36, 95% CI 0.18-0.72, p=0.004). Non-pharmacological interventions significantly reduced the risk of myocardial infarction (OR 0.36), cardiovascular-related readmission (OR 0.32), and cardiovascular-related death (OR 0.44) in patients who underwent percutaneous coronary intervention.
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