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Cited by 701Cardiac Health and Mental HealthCardiovascular and exercise physiologyAcute Myocardial Infarction Research

Efficacy of exercise-based cardiac rehabilitation post–myocardial infarction: A systematic review and meta-analysis of randomized controlled trials

Lawler, Patrick R., Filion, Kristian B., Eisenberg, Mark J.·2011·American Heart Journal
DOI 10.1016/j.ahj.2011.07.017
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Abstract

Background Exercise-based cardiac rehabilitation (CR) remains an underused tool for secondary prevention post-myocardial infarction (MI). In part, this arises from uncertainty regarding the efficacy of CR, particularly with respect to reinfarction, where previous studies have failed to show consistent benefit. We therefore undertook a meta-analysis of randomized controlled trials (RCTs) to (1) estimate the effect of CR on cardiovascular outcomes and (2) examine the effect of CR program characteristics on the magnitude of CR benefits.Methods We systematically searched MEDLINE as well as relevant bibliographies to identify all English-language RCTs examining the effects of exercise-based CR among post-MI patients. Data were aggregated using random-effects models. Stratified analyses were conducted to examine the impact of RCT-level characteristics on treatment benefits.Results We identified 34 RCTs (N = 6,111). Overall, patients randomized to exercise-based CR had a lower risk of reinfarction (odds ratio [OR] 0.53, 95% CI 0.38-0.76), cardiac mortality (OR 0.64, 95% CI 0.46-0.88), and all-cause mortality (OR 0.74, 95% CI 0.58-0.95). In stratified analyses, treatment effects were consistent regardless of study periods, duration of CR, or time beyond the active intervention. Exercise-based CR had favorable effects on cardiovascular risk factors, including smoking, blood pressure, body weight, and lipid profile.Conclusions Exercise-based CR is associated with reductions in mortality and reinfarction post-MI. Our secondary analyses suggest that even shorter CR programs may translate into improved long-term outcomes, although these results need to be confirmed in an RCT.

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  • In a pooled individual-level analysis of 11 prospective cohort studies, replacing saturated fat with polyunsaturated fat was associated with 13% lower coronary heart disease risk for each 5% energy exchange (RR, 0.87; 95% CI, 0.70-0.97).

    “In comparison, in a pooled individual-level analysis of 11 prospective cohort studies, the specific exchange of polyunsaturated fat consumption in place of saturated fat was associated with lower CHD risk, with 13% lower risk for each 5% energy exchange (RR, 0.87; 95% CI, 0.70–0.97).”

    From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [79]

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Authors
Lawler, P. R., Filion, K. B., & Eisenberg, M. J.
Affiliations
  • McGill University Health Centre (CA)
  • University of Minnesota (US)
  • Jewish General Hospital (CA)
Corresponding author
Eisenberg, Mark J.
ORCID
Venue
American Heart Journal
Publisher
Elsevier BV
Published
2011-10
Volume
162
Issue
4
Pages
571-584.e2
ISSN
0002-8703 (ISSN-L)
DOI
10.1016/j.ahj.2011.07.017
OpenAlex
W1988610794
Cited by
701
References
72
Citations by year
2026: 24 · 2025: 21 · 2024: 34 · 2023: 39 · 2022: 52 · 2021: 65 · 2020: 62 · 2019: 59 · 2018: 46 · 2017: 43 · 2016: 79 · 2015: 56 · 2014: 55 · 2013: 40 · 2012: 22
FWCI
6.49
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Heart Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
exercise-based cardiac rehabilitation, myocardial infarction, reinfarction, cardiac mortality, all-cause mortality, secondary prevention, cardiovascular risk factors, smoking, blood pressure, body weight, lipid profile
MeSH terms
Exercise Therapy, Humans, Myocardial Infarction, Randomized Controlled Trials as Topic

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