The Effects of Cardiac Rehabilitation on Mortality and Morbidity in Women: a Meta-Analysis Attempt

Cardiac rehabilitation (CR) reduces mortality and morbidity. However, there have been few women in CR trials, and no meta-analyses. Thirty-one potential trials were identified in recent systematic reviews. All authors were contacted for data by sex as this was rarely reported. Data were only available for 2 trials.

Background: Cardiac rehabilitation (CR) is associated with significant reductions in mortality and morbidity, but few women are included in trials. Therefore, a meta-analysis of the effects of CR in women is warranted. Methods: Randomized controlled trials from recent systematic reviews that included women, attending comprehensive CR, and reporting the outcomes of mortality, morbidity (hospitalization, myocardial infarction, bypass surgery, percutaneous coronary intervention)were considered for inclusion. An updated search of the literature was performed from the end date of the last search, based on the Cochrane strategy. Authors were contacted to request results in women where not reported. Results: Based on 2 recent systematic reviews, 80 trials were identified. Fifty (62.5%) were excluded, most-commonly due to lack of inclusion of women (n=18; 22.5%).One trial was identified through the search update. Of 31 potential trials meeting inclusion criteria, one reported results in women, and many were old and hence data by sex were no longer available. Ultimately, data for women were available in 2. Therefore, it was deemed inappropriate to undertake meta-analysis. Conclusion: This review corroborates the dearth of data on CR in women, despite the fact that it is their leading cause of death. Given the totality of evidence, including reductions in mortality and morbidity in non-randomized studies, and evidence of benefit for other important outcomes such as functional capacity and quality of life, women should continue to be referred to CR.