Exercise-based cardiac rehabilitation for patients with angina pectoris - a CaReMATCH individual participant data meta-analysis

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Angina pectoris (stable and unstable) (n=286). Intervention: Exercise-based cardiac rehabilitation (ExCR) vs. Usual care without any structured exercise prescription. Primary outcome: Health-related quality of life (HRQoL) measured as standardized Z-scores up to 12 months (SMD 0.252, 95% CI 0.037 to 0.467).

Q: What does this research mean for the field?

Exercise-based cardiac rehabilitation significantly improves health-related quality of life up to 12 months compared to usual care in patients with angina pectoris. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Iris A. de Koning; Joyce M Heutinck; Benjamin J. R. Buckley; Grace Olivia Dibben; Gianluca Calogero Campo; Arto Jorma Hautala; Johan Aernout Snoek; Ralph Maddison; Nuria Santaularia; Scott Alexander Lear; Julie Houle; Gregory Y.H. Lip; Robert Jan M. van Geuns; Tom Vromen; Hareld Kemps; Rod Taylor; Niels A. Stens; Dick H. J. Thijssen; Alun David Hughes; Ajay Vamadevan S; Ambalam M. Chandrasekaran; Ambuj Roy; Andrea Raisi; Anil Ranjeetmal Jain; Arnoud W.J. van ’t Hof; Bhaskara Rao; Bishav Mohan; Davinder Singh Chadha; Dimple Kondal; Divya Soni; Dorairaj Prabhakaran; Ed P. de Kluiver; Elisabetta Tonet; Gianni Mazzoni; Giovanni Grazzi; Ian Roberts; Jabir Abdullakutty; Kalpana Kumari Singh; Kaushik Chattopadhyay; Kavita Singh; Kolli Suhas Reddy; Kushal Madan; Manjunath Cholenahally Nanjappa; Nagamalesh Udigala Madappa; Nagraj Desai; Narsimhan Calambur; Kalpana Natrajan; Nikhil Tandon; Nishi Chathurvedi; Paul Poirier; Poppy Malinson; P. N. Bhat; Pradeep A. Praveen; Prakash C Negi; Prasad MR; Raghava Sarma; Raji Devarajan; Ravindra K. Tongia; Rita Pavasini; Kanchanahalli Siddegowda Sadananda; Sanjay Kinra; Satish Patil; Shah B J Ebrahim; Shankar Patil; Sharad Chandra; Srikumar Swaminathan; Srinivas Mallya; Stefano Volpato; Stuart Pocock; Subhash C. Manchanda; Subramaniam Natarajan; Sudhir R. Naik; Sunil Kumar

doi:10.1016/j.ajpc.2026.101535

March 10, 2026ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)Open Access

Exercise-based cardiac rehabilitation for patients with angina pectoris - a CaReMATCH individual participant data meta-analysis

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Key result

Exercise-based cardiac rehab improves quality of life over usual care in angina pectoris.

SMD 0.252
95% CI 0.037 to 0.467
n=286

Why the study?

Randomized controlled trials evaluating the contemporary benefits of exercise-based cardiac rehabilitation in patients with angina pectoris are scarce and limited by small sample sizes and design heterogeneity.

Does exercise-based cardiac rehabilitation improve health-related quality of life in patients with angina pectoris?

Study Design

Type

Meta-Analysis (n=286)

Randomization

Individual participant data from 7 randomized controlled trials

Multicenter

Yes

Structured PICO

Does exercise-based cardiac rehabilitation improve health-related quality of life in patients with angina pectoris?

P

Population

286 adults (mean age 68 years, 19.9% female) with stable or unstable angina pectoris across 7 contemporary RCTs, followed for a median of 12.5 months.

I

Intervention

Exercise-based cardiac rehabilitation (ExCR), supervised or non-supervised, with or without additional psychosocial or educational intervention, managed in an outpatient, community-, or home-based setting (often home-based in 4 trials, or combined with center-based sessions in 2 trials), with all trials including aerobic exercise.

C

Comparator

Usual care without any structured exercise prescription (non-ExCR controls).

O

Outcome

Health-related quality of life (HRQoL) up to a maximum follow-up of 12 months, measured using validated questionnaires (EQ-5D, SF-36, 15D, and Quality of Life Index – cardiac version) and analyzed as standardized scores (Z-scores).patient reported

Main Result

Standardized Mean Difference: 0.252 (95% CI 0.037–0.467)

Contemporary exercise-based cardiac rehabilitation significantly improves health-related quality of life up to 12 months in patients with angina pectoris, supporting its use for symptom and quality-of-life management in chronic coronary syndromes.

Limitations

Unable to distinguish between patients with stable and unstable angina pectoris in several included trials
No data available on the timing of revascularisation prior to exercise-based cardiac rehabilitation
Relatively small sample size, low event rate, and short follow-up limited power to detect differences in mortality and hospitalisation
No data on timing of revascularisation prior to ExCR was available
Relatively low event rate, small sample size, and short follow-up for mortality and hospitalisation outcomes

Implication

Supports integration into angina care pathways; confirms and extends Level 1 evidence for cardiac rehabilitation.

Abstract

Contains fulltext : 333455.pdf (Publisher’s version ) (Open Access)

Discussion

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Cite This Study

Koning et al. (2026) conducted a meta-analysis in Angina pectoris (stable and unstable) (n=286). Exercise-based cardiac rehabilitation (ExCR) vs. Usual care without any structured exercise prescription was evaluated on Health-related quality of life (HRQoL) measured as standardized Z-scores up to 12 months (SMD 0.252, 95% CI 0.037 to 0.467). Exercise-based cardiac rehabilitation significantly improved health-related quality of life up to 12 months compared to usual care in patients with angina pectoris (SMD 0.252, 95% CI 0.037-0.467).

synapsesocial.com/papers/6ae23b08753158bca052aa11 https://doi.org/10.1016/j.ajpc.2026.101535

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Exercise-based cardiac rehabilitation for patients with angina pectoris - a CaReMATCH individual participant data meta-analysis

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Exercise-based cardiac rehabilitation for patients with angina pectoris - a CaReMATCH individual participant data meta-analysis

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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