Evidence map›Paper›PMID 36746187›Full record

SynthesisEuropean heart journal2023

Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis.

Grace O Dibben, James Faulkner, Neil Oldridge, Karen Rees, David R Thompson, Ann-Dorthe Zwisler, Rod S Taylor

Registry-linked trialAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07613762 (Effect of High-Flow Nasal Cannula Use on Exercise Tolerance and Physical Performance in Heart Failure Patients Enrolled in a Cardiac Rehabilitation Program), which is not on this map. Cited by 250 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
250citing papers in PubMed, 16 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.

NCT07613762 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Effect of High-Flow Nasal Cannula Use on Exercise Tolerance and Physical Performance in Heart Failure Patients Enrolled in a Cardiac Rehabilitation Program: A Randomized Crossover Trial

TypeinterventionalSponsorUniversidad de Santiago de ChileRan2026 to 2027Enrolled28ConditionsHeart Failure, Exercise Tolerance (Measured in Minutes), Cardiac RehabilitationArmsHigh-Flow Nasal Cannula (HFNC)
3 · Its place in the literature

Who cites it

250 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Grace O DibbenMRC/CSO Social and Public Health Sciences Unit, Institute of Health and Well Being, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7254-5187
James FaulknerSchool of Sport, Health and Community, Faculty Health and Wellbeing, University of Winchester, Winchester, UK.
Neil OldridgeCollege of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Karen ReesDivision of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
David R ThompsonSchool of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.ORCID 0000-0001-8518-6307
Ann-Dorthe ZwislerREHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.ORCID 0000-0002-9241-2090
Rod S TaylorMRC/CSO Social and Public Health Sciences Unit, Institute of Health and Well Being, University of Glasgow, Glasgow, UK.

Funding

Medical Research Council MC_UU_00022/1Scottish Government Chief Scientist Office SPHSU16
6 · The paper itself

Abstract

aimsCoronary heart disease is the most common reason for referral to exercise-based cardiac rehabilitation (CR) globally. However, the generalizability of previous meta-analyses of randomized controlled trials (RCTs) is questioned. Therefore, a contemporary updated meta-analysis was undertaken. METHODS AND

resultsDatabase and trial registry searches were conducted to September 2020, seeking RCTs of exercise-based interventions with ≥6-month follow-up, compared with no-exercise control for adults with myocardial infarction, angina pectoris, or following coronary artery bypass graft, or percutaneous coronary intervention. The outcomes of mortality, recurrent clinical events, and health-related quality of life (HRQoL) were pooled using random-effects meta-analysis, and cost-effectiveness data were narratively synthesized. Meta-regression was used to examine effect modification. Study quality was assessed using the Cochrane risk of bias tool. A total of 85 RCTs involving 23 430 participants with a median 12-month follow-up were included. Overall, exercise-based CR was associated with significant risk reductions in cardiovascular mortality [risk ratio (RR): 0.74, 95% confidence interval (CI): 0.64-0.86, number needed to treat (NNT): 37], hospitalizations (RR: 0.77, 95% CI: 0.67-0.89, NNT: 37), and myocardial infarction (RR: 0.82, 95% CI: 0.70-0.96, NNT: 100). There was some evidence of significantly improved HRQoL with CR participation, and CR is cost-effective. There was no significant impact on overall mortality (RR: 0.96, 95% CI: 0.89-1.04), coronary artery bypass graft (RR: 0.96, 95% CI: 0.80-1.15), or percutaneous coronary intervention (RR: 0.84, 95% CI: 0.69-1.02). No significant difference in effects was found across different patient groups, CR delivery models, doses, follow-up, or risk of bias.

conclusionThis review confirms that participation in exercise-based CR by patients with coronary heart disease receiving contemporary medical management reduces cardiovascular mortality, recurrent cardiac events, and hospitalizations and provides additional evidence supporting the improvement in HRQoL and the cost-effectiveness of CR.

Indexed as

Cardiac RehabilitationCoronary DiseaseMyocardial InfarctionAdultExerciseExercise TherapyHumansQuality of LifeCardiac rehabilitationCoronary heart diseaseExercise trainingPhysical activityPrevention

Identifiers

PMID36746187
PMCPMC9902155

What OpenQuestion holds

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Registered trials

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.