title: Interval training versus continuous exercise in patients with coronary artery disease: a meta-analysis.
abstract: BACKGROUND
  High aerobic capacity is inversely related to cardiovascular disease morbidity and mortality. Recent studies suggest greater improvements in aerobic capacity with high-intensity interval training (interval) compared to moderate-intensity continuous aerobic exercise (continuous). Therefore we perform a meta-analysis of randomised controlled trials comparing the effectiveness of INTERVAL versus CONTINUOUS in aerobic capacity, amongst patients with stable coronary artery disease (CAD) and preserved ejection fraction
  
  
  METHODS
  We searched PubMed, EMBASE, CINAHL, the Australia and New Zealand Clinical Trials Register, clinicaltrials.gov and TROVE for randomised controlled trials comparing INTERVAL with CONTINUOUS in patients with CAD. Studies published in the English language up to December 2013 were eligible for inclusion. Aerobic capacity, quantified by peak oxygen consumption (VO2peak) post exercise training was extracted and compared post-intervention between INTERVAL and CONTINUOUS by way of a fixed model meta-analysis. Secondary outcomes including anaerobic threshold, blood pressure and high-density lipoproteins (HDL) were also analysed.
  
  
  RESULTS
  Six independent studies with 229 patients (n=99 randomised to INTERVAL) were included in the meta-analysis. There was a significantly higher increase in VO2peak following INTERVAL compared to CONTINUOUS (Weighted Mean Difference=1.53 ml•kg(-1)min(-1), 95% CI 0.84 to 2.23) with homogeneity displayed between studies (Chi Squared=2.69; P=0.7). Significant effects of INTERVAL compared to CONTINUOUS were also found for anaerobic threshold but not systolic blood pressure.
  
  
  CONCLUSIONS
  In patients with CAD, INTERVAL appears more effective than CONTINUOUS for the improvement of aerobic capacity in patients with CAD. However, long-term studies assessing morbidity and mortality following INTERVAL are required before this approach can be more widely adopted.
authors.affiliation: School of Medical Sciences, University of Adelaide, Australia; School of Translational Health Science, University of Adelaide, Australia. Electronic address: adrian.elliott@adelaide.edu.au.
authors.forename: Adrian D
authors.initials: AD
authors.lastname: Elliott
authors.affiliation: The Queen Elizabeth Hospital and Discipline of Medicine, University of Adelaide, Australia.
authors.forename: Kanchani
authors.initials: K
authors.lastname: Rajopadhyaya
authors.affiliation: School of Medical Sciences, University of Adelaide, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bentley
authors.affiliation: The Queen Elizabeth Hospital and Discipline of Medicine, University of Adelaide, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Beltrame
authors.affiliation: School of Translational Health Science, University of Adelaide, Australia.
authors.forename: Edoardo C
authors.initials: EC
authors.lastname: Aromataris
mesh_terms: D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology* / Q000628:therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood*; D039781:PubMed; D016032:Randomized Controlled Trials as Topic
chemical_list: D010100:Oxygen
keywords: Coronary artery bypass graft; Myocardial infarction; Oxygen uptake; Rehabilitation; Risk factors