Evidence map›Paper›PMID 30255969›Full record

SynthesisEuropean journal of heart failure2018

Impact of exercise-based cardiac rehabilitation in patients with heart failure (ExTraMATCH II) on mortality and hospitalisation: an individual patient data meta-analysis of randomised trials.

Rod S Taylor, Sarah Walker, Neil A Smart, Massimo F Piepoli, Fiona C Warren, Oriana Ciani, Christopher O'Connor, David Whellan, Steven J Keteyian, Andrew Coats and 13 more

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024
    Pooled it
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  3. Guideline
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  11. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
  12. Trial
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  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Review
  20. Exercise Prescription in Cardio-Oncology.Journal of clinical medicine · 2025
    Review

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Rod S TaylorInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Sarah WalkerInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Neil A SmartUniversity of New England, Armidale, Australia.
Massimo F PiepoliCardiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Fiona C WarrenInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Oriana CianiInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Christopher O'ConnorDuke Clinical Research Institute, North Carolina, NC, USA.
David WhellanDepartment of Medicine, Sidney Kimmel Medical College, Philadelphia, PA, USA.
Steven J KeteyianDepartment of Medicine, Henry Ford Hospital, Detroit, MI, USA.
Andrew CoatsIRCCS, San Raffaele Pisana, Rome, Italy.
Constantinos H DavosCardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
Hasnain M DalalInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Kathleen DracupSchool of Nursing, University of California San Francisco, CA, USA.
Lorraine EvangelistaUniversity of California, Irvine, CA, USA.
Kate JollyInstitute of Applied Health Research, University of Birmingham, UK.
Jonathan MyersPalo Alto Health Care System/Stanford University, Palo Alto, CA, USA.
Robert S McKelvieSt. Joseph's Health Care Centre, London, Canada.
Birgitta B NilssonDivision of Medicine, Oslo University Hospital and Faculty of Health Sciences, Oslo Metropolitan University, Norway.
Claudio PassinoFondazione G. Monasterio and Scuola Superiore Sant'Anna, Pisa, Italy.
Miles D WithamSchool of Medicine, University of Dundee, Dundee, UK.
Gloria Y YehDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Ann-Dorthe O ZwislerNational Knowledge Centre for Rehabilitation and Palliative Care, University Hospital Odense and University of Southern Denmark, Nyborg, Denmark.
ExTraMATCH II Collaboration

Funding

Tai Chi Mind-Body Therapy for Chronic Heart FailureR01AT002454 · NCCIH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI PHILLIPS, RUSSELL SCOTT · 2004 to 2007
$2.3M
Mentoring and Patient-Oriented Research in Mind-Body ExerciseK24AT009465 · NCCIH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI GLORIA Y YEH · 2017 to 2026
$1.3M
Department of Health HTA/15/80/30Department of Health RP-PG-1210-12004NCCIH NIH HHS K24 AT009465NCCIH NIH HHS R01 AT002454
6 · The paper itself

Abstract

aimsTo undertake an individual patient data (IPD) meta-analysis to assess the impact of exercise-based cardiac rehabilitation (ExCR) in patients with heart failure (HF) on mortality and hospitalisation, and differential effects of ExCR according to patient characteristics: age, sex, ethnicity, New York Heart Association functional class, ischaemic aetiology, ejection fraction, and exercise capacity. METHODS AND

resultsRandomised trials of exercise training for at least 3 weeks compared with no exercise control with 6-month follow-up or longer, providing IPD time to event on mortality or hospitalisation (all-cause or HF-specific). IPD were combined into a single dataset. We used Cox proportional hazards models to investigate the effect of ExCR and the interactions between ExCR and participant characteristics. We used both two-stage random effects and one-stage fixed effect models. IPD were obtained from 18 trials including 3912 patients with HF with reduced ejection fraction. Compared to control, there was no statistically significant difference in pooled time to event estimates in favour of ExCR although confidence intervals (CIs) were wide [all-cause mortality: hazard ratio (HR) 0.83, 95% CI 0.67-1.04; HF-specific mortality: HR 0.84, 95% CI 0.49-1.46; all-cause hospitalisation: HR 0.90, 95% CI 0.76-1.06; and HF-specific hospitalisation: HR 0.98, 95% CI 0.72-1.35]. No strong evidence was found of differential intervention effects across patient characteristics.

conclusionExercise-based cardiac rehabilitation did not have a significant effect on the risk of mortality and hospitalisation in HF with reduced ejection fraction. However, uncertainty around effect estimates precludes drawing definitive conclusions.

Indexed as

HospitalizationQuality of LifeCardiac RehabilitationExerciseExercise TherapyGlobal HealthHeart FailureHumansRandomized Controlled Trials as TopicSurvival RateCardiac rehabilitationExercise trainingMeta-analysisSystematic review

Identifiers

PMID30255969
PMCPMC7262555

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.