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Cardiac Rehabilitation Programs for Chronic Heart Disease: A Bayesian Network Meta-analysis.

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机构: [1]Department of Gerontology, the Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Chongqing, China [2]Department of Medicine, University of Otago - Christchurch, Christchurch, New Zealand [3]Department of Cardiothoracic Surgery,the First People's Hospital of Yunnan Province,Kunming,Yunnan Province,China [4]Institute of Ultrasound Imaging, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China [5]Department of Rehabilitation Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China [6]Statistical Laboratory, Chuang Xu Institute of Lifesciences, Chongqing, China [7]Impactys Foundation for Biomedical Research, San Diego, CA, USA [8]Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy [9]Department of Cardiology,the First People 's Hospital of Yunnan Province,No.157,Jinbi Road,Kunming,Yunnan Province,China
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Cardiac rehabilitation is a medically supervised program after coronary events that involves exercise and dietary modification. We evaluated the comparative benefits and harms of cardiac rehabilitation strategies via a network meta-analysis. We followed a pre-specified protocol (PROSPERO: CRD42018094998). We searched Embase, MEDLINE, and Cochrane Central Register of Randomized Trials databases for randomized controlled trials that evaluated cardiac rehabilitation vs a second form of rehabilitation or standard/usual care in adults after myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or angiography. Risk of bias and evidence quality was evaluated using the Cochrane tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. Pairwise and Bayesian network meta-analyses were performed for 11 clinical outcomes. We included 134 randomized controlled trials involving 62,322 participants. Compared with standard care, exercise-only cardiac rehabilitation reduced the odds of cardiovascular mortality (odds ratio [OR], 0.70; 95% credibility interval [CrI], 0.51-0.96; moderate-quality evidence), major adverse cardiovascular events (OR, 0.57; 95% CrI, 0.40-0.78; low-quality evidence), nonfatal myocardial infarction (OR, 0.71; 95% CrI, 0.54-0.93; moderate-quality evidence), all-cause hospitalization (OR, 0.74; 95% CrI, 0.54-0.98; moderate-quality evidence), and cardiovascular hospitalization (OR, 0.69; 95% CrI, 0.51-0.88; moderate-quality evidence). Exercise-only cardiac rehabilitation was associated with lower cardiovascular hospitalization risk relative to cardiac rehabilitation without exercise (OR, 0.68; 95% CrI, 0.48-0.97; moderate-quality evidence). Cardiac rehabilitation programs containing exercise might provide broader cardiovascular benefits compared with those without exercise. Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2020]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者机构: [1]Department of Gerontology, the Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Chongqing, China
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通讯机构: [1]Department of Gerontology, the Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Chongqing, China [8]Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy [*1]Department of Emergency and Organ Transplantation University of Bari, 70124 Bari, Italy [*2]Department of Gerontology The Second Affiliated Hospital of Chongqing Medical University No. 76, Linjiang road, Chongqing, China
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