Conclusions Exercise-based cardiac rehabilitation is effective at reducing important clinical outcomes in patients with coronary heart disease .
While our analysis was constrained by the quality of included trials and missing information about intervention components , there appears to be little differential effect of variations in exercise intervention , particularly on mortality outcomes .
Background While the clinical benefits of exercise-based cardiac rehabilitation are well established , there is extensive variation in the interventions used within these trials .
It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes .
This study aims to systematic ally examine the relationship between individual components of the exercise intervention in cardiac rehabilitation ( such as intensity and frequency ) and clinical outcomes for people with coronary heart disease .
A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention.
OBJECTIVE To evaluate the long-term effect of a cardiac rehabilitation and prevention program ( CRPP ) on quality of life ( QOL ) and its cost effectiveness . DESIGN Prospect i ve , r and omized controlled trial . SETTING University-affiliated outpatient cardiac rehabilitation and prevention center . PARTICIPANTS A total of 269 patients ( 76 % men ; mean age , 64+/-11 y ) with recent acute myocardial infa rct ion ( AMI ; n=193 ) or after elective percutaneous coronary intervention ( PCI ; n=76 ) were r and omized in a ratio of 2 to 1 . INTERVENTION Patients received either CRPP ( an 8-wk exercise and education class in phase 2 ) or conventional therapy without exercise program ( control group ) . They were followed until they had completed all 4 phases of the program ( ie , 2 y ) . MAIN OUTCOME MEASURES QOL assessment s , by using the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) and Symptoms Question naire , were performed at the end of each phase . Direct health care cost was calculated , whereas cost utility was estimated as money spent ( in US dollars ) per quality -adjusted life-year ( QALY ) gained . RESULTS In the CRPP group , 6 of the 8 SF-36 dimensions improved significantly by phase 2 and were maintained throughout the study period . Patients were less anxious and depressed , and felt more relaxed and contented . In the control group , none of the SF-36 dimensions were improved by phase 2 , and bodily pain was increased . In phase 4 , only 4 dimensions were improved . Symptoms were unchanged except for increased hostility score . There was a significant gain in net time trade-off in the CRPP group after phase 2 . The direct health care expenses in the CRPP and control groups were 15,292 dollars and 15,707 dollars per patient , respectively . Therefore , the cost utility calculated was 640 dollars saved per QALY gained . Savings attributable to CRPP were primarily explained by the lower rate ( 13 % vs 26 % of patients , chi2 test=3.9 , P < .05 ) and cost of subsequent PCI ( P = .01 ) . CONCLUSIONS In an era of managing patients with coronary heart disease , a short-course CRPP was highly cost effective in providing better QOL to patients with recent AMI or after elective PCI . In addition , the improvement of QOL was quick and sustained for at least 2 years after CRPP
Conclusions Exercise-based cardiac rehabilitation is effective at reducing important clinical outcomes in patients with coronary heart disease .
While our analysis was constrained by the quality of included trials and missing information about intervention components , there appears to be little differential effect of variations in exercise intervention , particularly on mortality outcomes .
Background While the clinical benefits of exercise-based cardiac rehabilitation are well established , there is extensive variation in the interventions used within these trials .
It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes .
This study aims to systematic ally examine the relationship between individual components of the exercise intervention in cardiac rehabilitation ( such as intensity and frequency ) and clinical outcomes for people with coronary heart disease .