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June 1, 2019ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)Open Access

Exercise-based cardiac rehabilitation for stable angina had an uncertain effect on all-cause mortality (RR 1.01; 95% CI 0.18-5.67) but moderately improved short-term exercise capacity.

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Why the study?

The effects of exercise-based cardiac rehabilitation in patients with stable angina needed systematic assessment across randomized trials.

Does exercise-based cardiac rehabilitation improve clinical outcomes and exercise capacity in adults with stable angina?

Population

581 patients across seven randomized trials with stable angina

Comparison

Exercise-based CR programmes vs no exercise control

Design

Systematic review and meta-analysis of randomised trials

Follow-up

Median of 12-month

Key result

Exercise-based cardiac rehabilitation for stable angina had an uncertain effect on all-cause mortality (RR 1.01; 95% CI 0.18-5.67) but moderately improved short-term exercise capacity.

Authors

LLLinda LongLALindsey AndersonJHJingzhou He

Discussion

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Overview

Uncertainty around mortality reduction cautions against relying on cardiac rehabilitation for survival gains in stable angina; leaves open whether larger trials confirm hard-endpoint benefits.

Study Design

Type

Meta-Analysis (n=581)

Randomization

Randomized trials

Structured PICO

Does exercise-based cardiac rehabilitation improve clinical outcomes and exercise capacity in adults with stable angina?

P
Population
581 adults with stable angina (pooled from 7 randomised trials)
I
Intervention
Exercise-based cardiac rehabilitation (CR) programmes
C
Comparator
No exercise control
O
Outcome
All-cause mortality, acute myocardial infarction, cardiovascular-related hospital admissions, and exercise capacity

Main Result

Effect estimate: RR 1.01 (95% CI 0.18 to 5.67)

Exercise-based cardiac rehabilitation improves short-term exercise capacity in patients with stable angina, but its impact on mortality and morbidity remains uncertain due to low-quality evidence.

Limitations

  • Low-quality evidence for exercise capacity
  • Limited and very low-quality evidence for health-related quality of life, adverse events, and costs
  • No data on cost-effectiveness or return to work
  • low-quality evidence for exercise capacity
  • limited and very low-quality evidence for HRQoL, adverse events and costs
  • no data identified on cost-effectiveness or return to work

Cite This Study

Long et al. (2019) conducted a meta-analysis in Stable angina (n=581). Exercise-based cardiac rehabilitation vs. No exercise control was evaluated on All-cause mortality (RR 1.01, 95% CI 0.18 to 5.67). Exercise-based cardiac rehabilitation for stable angina had an uncertain effect on all-cause mortality (RR 1.01; 95% CI 0.18-5.67) but moderately improved short-term exercise capacity.

synapsesocial.com/papers/6a12baf3257f24f1de9e30b8https://doi.org/10.1136/openhrt-2018-000989
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