Effect of Cardiac Rehabilitation Dose on Mortality and Morbidity: A Systematic Review and Meta-regression Analysis
| dc.contributor.author | Santiago de AraújoPio, Carolina | |
| dc.contributor.author | Marzolini, Susan | |
| dc.contributor.author | Kin, R. | |
| dc.contributor.author | Pakosh, Maureen | |
| dc.contributor.author | Grace, Sherry | |
| dc.date.accessioned | 2021-01-28T16:07:43Z | |
| dc.date.available | 2021-01-28T16:07:43Z | |
| dc.date.issued | 2017-11 | |
| dc.description.abstract | OBJECTIVE: To ascertain the effect of CR dose (i.e., duration x frequency/week; categorized as low [<12 sessions], medium [12-35], or high [≥36]) on mortality and morbidity. PATIENTS AND METHODS: The Cochrane, CINAHL, EMBASE, PsycINFO and MEDLINE databases were systematically searched from inception through November30,2015. Inclusion criteria included randomized or non-randomized studies, with a minimum CR dose ≥4, and presence of a control/comparison group. Citations were considered for inclusion, and data were extracted in included studies independently by 2 investigators. Studies were pooled using random-effects meta-analysis, and meta-regression where warranted(covariates included study quality, country, publication year, and diagnosis).RESULTS: Of 4630 unique citations, 33 trials were included comparing CR to usual care (i.e., no dose).In meta-regression, greater dose was significantly related to lower all-cause mortality (high= -.77, Standard Error [SE]=.22, P<.001; medium=-0.80,SE=0.21, P<.001), when compared to low dose. With regard to morbidity, meta-analysis showed dose was significantly associated with less percutaneous coronary intervention (PCI; high: RR=.65, 95% CI .50-.84, and medium/low: RR=1.04, 95% CI .74-1.48; P=.03).This was also significant in meta-regression (high vs. medium/low=-.73, SE=.20, P<.001). Publication bias was not evident. No dose-response association was found for cardiovascular mortality, all-cause hospitalization, coronary artery bypass graft surgery, or myocardial infarction. CONCLUSION:A minimum of 36 CR sessions may be needed to reduce PCI. Future studies should examine the effect of actual dose of CR, and trials are needed comparing different doses. | en_US |
| dc.identifier.citation | Mayo Clinic Proceedings Volume 92, Issue 11, November 2017, Pages 1644-1659 | en_US |
| dc.identifier.issn | 0025-6196 | |
| dc.identifier.uri | https://doi.org/10.1016/j.mayocp.2017.07.019 | en_US |
| dc.identifier.uri | http://hdl.handle.net/10315/38072 | |
| dc.language.iso | en | en_US |
| dc.publisher | Elsevier | en_US |
| dc.rights | Elsevier Journals © <2017>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0 | en_US |
| dc.rights | Attribution-NoDerivatives 4.0 International | * |
| dc.rights.article | https://www.sciencedirect.com/science/article/abs/pii/S0025619617306419 | en_US |
| dc.rights.journal | https://www.sciencedirect.com/journal/mayo-clinic-proceedings | en_US |
| dc.rights.publisher | https://www.sciencedirect.com/ | en_US |
| dc.rights.uri | http://creativecommons.org/licenses/by-nd/4.0/ | * |
| dc.title | Effect of Cardiac Rehabilitation Dose on Mortality and Morbidity: A Systematic Review and Meta-regression Analysis | en_US |
| dc.type | Article | en_US |