336: Exercise-based cardiac rehabilitation effective for coronary heart disease

November 01, 2011

PEARLS 336, written by Brian R McAvoy

Clinical question: How effective is exercise-based cardiac rehabilitation on mortality, morbidity and health-related quality of life (QOL) in patients with coronary heart disease (CHD)?

Bottom line: Compared with usual care, in medium to longer-term follow-up (12 or more months) exercise-based cardiac rehabilitation was found to be effective in reducing overall and cardiovascular mortality in patients with CHD, and appeared to reduce the risk of hospital admissions in the shorter term (<12 months follow-up). There was no reduction seen in the risk of total myocardial infarction, coronary artery bypass graft or percutaneous transluminal coro.nary angioplasty.

Caveat: There appears to be little difference between exercise alone, or in combination with psychosocial or educational cardiac rehabili.tation interventions. There were insufficient data to definitely conclude that exercise-based cardiac rehabilitation improves health-related QOL compared with control. Despite inclusion of more recent trials, the population studied was predominantly male, middle-aged and low risk.

Context: The burden of CHD worldwide is one of concern to patients and healthcare agencies alike. Exercise-based cardiac rehabilitation aims to improve health outcomes for people with CHD through either regular exercise alone, or a combination of exercise with education and psychological support.

Cochrane Systematic Review: Heran BS, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Reviews, 2011, Issue 7. Article No. CD001800. DOI: 10.1002/14651858.CD001800.pub2. This review contains 47 studies involving 10,794 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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