Sangam: A Confluence of Knowledge Streams

Impact of exercise-based cardiac rehabilitation in patients with heart failure (ExTraMATCH II) on mortality and hospitalisation: an individual patient data meta-analysis of randomised trials

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dc.creator Taylor, RS
dc.creator Walker, S
dc.creator Smart, NA
dc.creator Piepoli, MF
dc.creator Warren, FC
dc.creator Ciani, O
dc.creator O'Connor, C
dc.creator Whellan, D
dc.creator Keteyian, SJ
dc.creator Coats, A
dc.creator Davos, CH
dc.creator Dalal, HM
dc.creator Dracup, K
dc.creator Evangelista, L
dc.creator Jolly, K
dc.creator Myers, J
dc.creator McKelvie, RS
dc.creator Nilsson, BB
dc.creator Passino, C
dc.creator Witham, MD
dc.creator Yeh, GY
dc.creator Zwisler, A-DO
dc.creator ExTraMATCH II Collaboration
dc.date 2018-11-22T13:18:07Z
dc.date 2018-09-26
dc.date.accessioned 2022-05-27T01:02:48Z
dc.date.available 2022-05-27T01:02:48Z
dc.identifier Published online 26 September 2018
dc.identifier 10.1002/ejhf.1311
dc.identifier http://hdl.handle.net/10871/34870
dc.identifier European Journal of Heart Failure
dc.identifier.uri http://localhost:8080/xmlui/handle/CUHPOERS/241910
dc.description This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record
dc.description AIMS: To undertake an individual patient data (IPD) meta-analysis to assess the impact of exercise-based cardiac rehabilitation (ExCR) in patients with heart failure (HF) on mortality and hospitalisation, and differential effects of ExCR according to patient characteristics: age, sex, ethnicity, New York Heart Association functional class, ischaemic aetiology, ejection fraction, and exercise capacity. METHODS AND RESULTS: Randomised trials of exercise training for at least 3 weeks compared with no exercise control with 6-month follow-up or longer, providing IPD time to event on mortality or hospitalisation (all-cause or HF-specific). IPD were combined into a single dataset. We used Cox proportional hazards models to investigate the effect of ExCR and the interactions between ExCR and participant characteristics. We used both two-stage random effects and one-stage fixed effect models. IPD were obtained from 18 trials including 3912 patients with HF with reduced ejection fraction. Compared to control, there was no statistically significant difference in pooled time to event estimates in favour of ExCR although confidence intervals (CIs) were wide [all-cause mortality: hazard ratio (HR) 0.83, 95% CI 0.67-1.04; HF-specific mortality: HR 0.84, 95% CI 0.49-1.46; all-cause hospitalisation: HR 0.90, 95% CI 0.76-1.06; and HF-specific hospitalisation: HR 0.98, 95% CI 0.72-1.35]. No strong evidence was found of differential intervention effects across patient characteristics. CONCLUSION: Exercise-based cardiac rehabilitation did not have a significant effect on the risk of mortality and hospitalisation in HF with reduced ejection fraction. However, uncertainty around effect estimates precludes drawing definitive conclusions.
dc.description This work is supported by UK National Institute for Health Research funding (HTA 15/80/30).
dc.language en
dc.publisher Wiley for European Society of Cardiology
dc.relation https://www.ncbi.nlm.nih.gov/pubmed/30255969
dc.rights © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology
dc.rights 2019-09-26
dc.rights Under embargo until 26 September 2019 in compliance with publisher policy
dc.subject Cardiac rehabilitation
dc.subject Exercise training
dc.subject Meta-analysis
dc.subject Systematic review
dc.title Impact of exercise-based cardiac rehabilitation in patients with heart failure (ExTraMATCH II) on mortality and hospitalisation: an individual patient data meta-analysis of randomised trials
dc.type Article


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