What is the clinical evidence from this study?

Study design: Systematic Review. Population: Myocardial Infarction (n=180946). Intervention: Exercise-based cardiac rehabilitation. Primary outcome: Complications during cardiac rehabilitation (cardiac arrests, myocardial infarctions, and deaths).

June 29, 2022Open Access

The safety of exercise-based cardiac rehabilitation program in patients after Myocardial Infarction

Key Result

Exercise-based cardiac rehabilitation is highly safe, with only 124 complications (including 71 cardiac arrests and 15 myocardial infarctions) occurring among 180,946 patients.

Study Design

Type

Systematic Review (n=180,946)

Structured PICO

Does exercise-based cardiac rehabilitation cause severe complications in patients after myocardial infarction?

Population

180,946 patients participating in exercise-based cardiac rehabilitation programs after myocardial infarction or other cardiovascular events.

Intervention

Exercise-based cardiac rehabilitation (exCR) programs, including supervised inpatient and outpatient exercise sessions (calisthenics, endurance on stationary bike or treadmill) and fatigue tests.

Outcome

Safety and complication rates during or up to 1 hour after exercise sessions or fatigue tests, including cardiac arrests, myocardial infarctions, and deaths.safety

Exercise-based cardiac rehabilitation is highly safe for cardiovascular patients, with an extremely low rate of fatal and non-fatal complications during supervised sessions.

Limitations

Pre-2000 complication rates may not generalize to modern heart patients due to changes in treatments, older patient age, and more comorbidities.

Abstract

Objective: The aim of the present review is to identify the safety of an exercise-based cardiac rehabilitation program in patients after myocardial infarction. Materials and Methods: The PubMed/Medline and Scopus/Elsevier electronic databases were searched. A search strategy was developed based on the intersection of 2 search themes: cardiac rehabilitation program and exercise safety. Results: The articles that finally met all the inclusion criteria and were analyzed, after the screening of the title, the summary and the whole text, were 4. A total of 180.946 patients who received cardiac rehabilitation were examined in this review and 124 complications were occurred: 71 cardiac arrests (11 fatal), 15 myocardial infarctions (2 fatal), and 31 non-life-threatening patients: angina, ventricular tachycardia, 1 orthopedic injury and 4 deaths from cardiorespiratory disorder. Discussion: The present review has demonstrated that individualized and prescribed exercise-based cardiac rehabilitation is safe and recommended. The complications of these programs appear to be of low risk and with no statistical importance. The exercise-based cardiac rehabilitation when combined with patient participation, proper equipment and educated physicians present a very safe clinical approach to cardiovascular patients.

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