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Cardiac Rehabilitation After Myocardial Infarction: Combined Experience of Randomized Clinical Trials
Abstract
Randomized clinical trials of cardiac rehabilitation following myocardial infarction have typically demonstrated a lower mortality in treated patients, but with a statistically significant reduction in only one trial. To overcome the problem of not being able to detect small but clinically important benefits in mortality in randomized clinical trials of exercise and risk factor rehabilitation after myocardial infarction with small numbers of patients, we carried out a meta-analysis on the combined results of ten randomized clinical trials that included 4347 patients (control, 2145 patients; rehabilitation, 2202 patients). The pooled odds ratios of 0.76 (95% confidence intervals, 0.63 to 0.92) for all-cause death and of 0.75 (95% confidence intervals, 0.62 to 0.93) for cardiovascular death were significantly lower in the rehabilitation group than in the control group, with no significant difference for nonfatal recurrent myocardial infarction. These results suggest that, for appropriately selected patients, comprehensive cardiac rehabilitation has a beneficial effect on mortality but not on nonfatal recurrent myocardial infarction. (JAMA1988;260:945-950)
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“Several meta-analyses have concluded that comprehensive, exercise-based cardiac rehabilitation reduces mortality rates in patients after myocardial infarction.23,24”
From Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity) (2003) · cites this paper as [24]
In the citing paper
“This review 25 adds Ϸ4000 patients to the prior, widely cited meta-analyses of cardiac rehabilitation 23,24 and confirms that exercise-based cardiac rehabilitation reduces cardiac mortality but does not reduce the risk of recurrent myocardial infarction.”
From Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity) (2003) · cites this paper as [24]
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Fihn, S. D., Williams, S. V., Daley, J., & Gibbons, R. J. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-8_part_1-200110160-00014 · Cited by 64
Metadata
- Authors
- Oldridge, N. B.
- Corresponding author
- Oldridge, Neil B.
- ORCID
- Oldridge, Neil B.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1988-08-19
- Volume
- 260
- Issue
- 7
- Pages
- 945
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4322695695
- Semantic Scholar
- 656a77909d183420d453da7a6da80630db202005
- Cited by
- 800
- References
- 0
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 11 · 2021: 12 · 2020: 17 · 2019: 16 · 2018: 16 · 2017: 18 · 2016: 25 · 2015: 28 · 2014: 25 · 2013: 26 · 2012: 12
- FWCI
- 8.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- cardiac rehabilitation, myocardial infarction, all-cause mortality, cardiovascular mortality, reinfarction, exercise therapy
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