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 .
Cardiac rehabilitation and survival in older coronary patients.
OBJECTIVES This study assessed the effects of cardiac rehabilitation ( CR ) on survival in a large cohort of older coronary patients . BACKGROUND R and omized controlled trials and meta-analyses have shown that CR improves survival . However , trial participants have been predominantly middle-aged , low- or moderate-risk , white men . METHODS The population consisted of 601,099 U.S. Medicare beneficiaries who were hospitalized for coronary conditions or cardiac revascularization procedures . One- to 5-year mortality rates were examined in CR users and nonusers using Medicare cl aims and 3 analytic techniques : propensity-based matching , regression modeling , and instrumental variables . The first method used 70,040 matched pairs , and the other 2 techniques used the entire cohort . RESULTS Only 12.2 % of the cohort used CR , and those users averaged 24 sessions . Each technique showed significantly lower ( p < 0.001 ) 1- to 5-year mortality rates in CR users than nonusers . Five-year mortality relative reductions were 34 % in propensity-based matching , 26 % from regression modeling , and 21 % with instrumental variables . Mortality reductions extended to all demographic and clinical subgroups including patients with acute myocardial infa rct ions , those receiving revascularization procedures , and those with congestive heart failure . The CR users with 25 or more sessions were 19 % relatively less likely to die over 5 years than matched CR users with 24 or fewer sessions ( p < 0.001 ) . CONCLUSIONS Mortality rates were 21 % to 34 % lower in CR users than nonusers in this socioeconomically and clinical ly diverse , older population after extensive analyses to control for potential confounding . These results are of similar magnitude to those observed in published r and omized controlled trials and meta-analyses in younger , more selected population
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 .