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Do Cardiac Rehabilitation Affect Clinical Prognoses Such as Recurrence, Readmission, Revascularization, and Mortality After AMI?: Systematic Review and Meta-Analysis

Annals of Rehabilitation Medicine 2021년 45권 1호 p.57 ~ 70
김철, 최인선, 조송희, 김애령, 김원석, 지성주,
소속 상세정보
김철 ( Kim Chul ) - Inje University Sanggye Paik Hospital Department of Rehabilitation Medicine
최인선 ( Choi In-Sun ) - National Evidence-based Healthcare Collaborating Agency
조송희 ( Cho Song-Hee ) - National Evidence-Based Healthcare Collaborating Agency
김애령 ( Kim Ae-Ryoung ) - Kyungpook National University Hospital Department of Rehabilitation Medicine
김원석 ( Kim Won-Seok ) - Seoul National University Bundang Hospital Department of Rehabilitation Medicine
지성주 ( Jee Sung-Ju ) - Chungnam National University College of Medicine Department of Rehabilitation Medicine

Abstract


Objective: We conducted a systematic review and meta-analysis to analyze the effects of cardiac rehabilitation (CR) on post-discharge prognoses of patients with acute myocardial infarction (AMI).

Methods: A literature search was conducted through four international medical and two Korean databases. Primary outcomes for the effectiveness of CR included all-cause mortality, cardiovascular mortality, recurrence, revascularization, major adverse cardiovascular event, major adverse cardiocerebrovascular event, and readmission. We summarized and analyzed results of studies about CR for AMI, including not only randomized controlled trials (RCTs) but also non-RCTs. We calculated the effect size separately by the study type.

Results: Fourteen articles were finally selected. Of these, two articles were RCTs, while 12 were non-RCTs. In RCTs, the overall mortality rate was lower in the group that participated in CR than that in the conventional care group by 28% (relative risk=0.72; 95% confidence interval, 0.34?1.57). Among non-RCTs, CR participation significantly decreased the overall risk of mortality. Moreover, the rates of recurrence and major adverse cardiovascular events were lower in the group that participated in CR compared to those in the non-CR group.

Conclusion: The meta-analysis shows that CR reduces the risk of re-hospitalization and all-cause mortality after AMI, compared to no participation in CR. This outcome was seen in RCTs as well as in non-RCTs. More studies are necessary for concrete conclusions about the beneficial effects of CR after AMI in various settings.

키워드

Myocardial infarction; Cardiac rehabilitation; Recurrence; Readmission; Mortality

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