The Effects And Safety Of Exercise-based Cardiac Rehabilitation In Patients With Coronary Artery Disease After PCI:A Meta-analysis

Objective: Exercise-based cardiac rehabilitaton(EBCR)in China have a later start,although it develops somewhat,it is still in the beginning and rising stage.In recent years,there is no lack of exercise rehabilitation applied to research of coronary artery disease(CAD),but the results of these researchs are widely divided,such as the heart function,cardiovascular risk factors,exercise endurance,major adverse cardiovascular events(MACE),etc.To systematically evaluate the effects and safety of exercise-based cardiac rehabilitation in patients with coronary artery disease after percutaneous coronary intervention(PCI)by meta analysis,thereby providing reference for the improvement of cardiac function,exercise endurance,mental disease status,major adverse cardiovascular events.Methods: In this study,four major Chinese databases(CNKI,CBM,Wanfang,VIP)and four major English databases(Pub Med,The Cochrane Library,Web of Science,Embase)are used to search the randomized controlled trials(RCTs)that match the study.Then extract the data related to outcome indicators and evaluate the methodological quality of the literature.Next,we make the form about the general feature and quality evaluation.Finally,Rev Man5.3 software is used for statistical processing.Results: A total of 15 randomized controlled trials with 1307 patients are finally included,including 656 in the observation group and 651 in the control group.Compared with the conventional treatment group,Meta-analysis results show that exercise-based cardiac rehabilitation can effectively increase left ventricular ejection fraction(LVEF)[MD=2.83,95%CI(1.53,4.14),P=0.0001],effectively shorten left ventricular end-diastolic dimension(LVEDD)[MD=-2.42,95%CI(-3.87,-0.96),P=0.001],effectively reduce New York Heart Association(NYHA)cardiac function grade [MD=-0.16,95%CI(-0.22,-0.09),P<0.00001],effectively prolong 6-minute walking distance(6MWD)[MD=41.72,95%CI(27.03,56.41),P<0.00001],effectively increase the metabolic equivalents(METs)[MD=1.23,95%CI(0.31,2.14),P=0.008],effectively reduce the self-rating anxiety scale(SAS)score [MD=-6.02,95%CI(-11.23,-0.81),P=0.02],effectively reduce the rate of coronary stent restenosis [RR=0.21,95%CI(0.08,0.53),P=0.0010],effectively reduce the recurrence rate of angina pectoris[RR=0.37,95%CI(0.21,0.66)],P=0.0007],effectively reduce the cardiac mortality rate [RR=0.11,95%CI(0.02,0.59),P=0.01],but there is no significant advantage in shortening the left ventricular end-systolic dimension(LVESD)[MD=-0.02,95%CI(-0.37,0.32),P=0.98],and reducing the reoccurrence rate of myocardial infarction [RR=0.36,95%CI(0.12,1.12),P=0.08] compare with the control group.Conclusion: The exercise-based cardiac rehabilitation can effectively improve patients’ cardiac function,exercise tolerance,mental state,and reduce the rate of stent restenosis,angina pectoris,cardiac mortality after PCI,but there is no obvious advantage in shortening LVESD,reducing the recurrence rate of myocardial infarction in a short time.