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The role of exercise-based cardiac rehabilitation after percutaneous coronary intervention in patients with coronary artery disease: a meta-analysis of randomised controlled trials.

Acta Cardiologica 2024 March 11
BACKGROUND: this study was designed to analyse patient outcomes using a combination of PCI and exercise-based cardiac rehabilitation compared with PCI alone.

METHODS: PCI can improve the survival rate of patients with coronary artery disease, but it can also cause vascular endothelial cell injury, thrombosis, and even restenosis. Early cardiac rehabilitation exercise is crucial for patients with coronary heart disease after PCI. Five databases were examined for randomised controlled trials involving early cardiac rehabilitation exercise and standard treatment in patients with coronary heart disease after PCI. The search period lasted from the creation of the database (2006) until December 2022. The outcomes including angina, arrhythmia, coronary restenosis, left ventricular ejection fraction, left ventricular end diastolic diameter, 6-min walk distance, total cholesterol, heart rate, systolic blood pressure and diastolic blood pressure. RevMan 5.3 was used to analyse the data, and the Cochrane Collaboration was used to assess the quality of evidence.

RESULTS: A total of 1231 patients were enrolled in this study. Angina pectoris (RR = 0.24, 95% CI [0.10, 0.57], p  = 0.001), Arrhythmia (RR = 0.17, 95% CI [0.05, 0.55], p  = 0.003), Coronary artery restenosis (RR = 0.10, 95% CI [0.01, 0.76], p  = 0.03).

CONCLUSION: Exercise after PCI improves LVEF, enhances 6MWD, lowers HR and minimises the risk of angina, arrhythmia and coronary artery restenosis in CHD patients. Exercise had no discernible effect on LVEDD, TC, SBP, or DBP.

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