Does post myocardial infarction rehabilitation prolong survival? A meta-analytic survey.
Cardiac rehabilitation undoubtedly helps post-myocardial infarction patients to feel better; however, it is under consideration whether or not it also prolongs their survival. Since 1972 several published studies have examined the role of physical rehabilitation in relation to patient survival after myocardial infarction. Eight randomized controlled trials were reviewed in order to compare the rate of events (total death, cardiac death, recurrence of non-fatal myocardial infarction) in the trained and untrained patient population. A tendency toward a positive training effect on survival was present in almost all trials; however, in only one study was the number of cardiac deaths shown to be significantly reduced in trained patients. The aim of this study was to use a quantitative analysis based on estimates of individual trials to evaluate the effect of post-myocardial infarction rehabilitation programs on survival. The analysis of pooled data revealed a significant decrease in total mortality (relative risk 0.68 with 95% confidence limits 0.53-0.86; p = 0.002), and cardiac mortality (relative risk 0.62 with 95% confidence limits 0.48-0.82; p less than 0.001). However, there was a non-significant increase in recurrences (relative risk 1.12 with 95% confidence limits 0.84-1.49; p = 0.45). These data are very similar to those found by another meta-analytic survey performed on a different set of published studies, i.e., odds risk for total death 0.76, for cardiac mortality 0.75 and for non-fatal myocardial infarction 1.15.(ABSTRACT TRUNCATED AT 250 WORDS)
Bobbio
M
M
Cattedra di Cardiologia, Università di Torino, Italy.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic