Effects of Exercise-Based Cardiac Rehabilitation on Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Xuedan Bao, Weiwei Hong, Liyao Feng
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Abstract

Objective: This study aims to systematically analyze the impact of exercise-based cardiac rehabilitation on patients undergoing percutaneous coronary intervention (PCI). Methods: We searched for original studies on the effect of exercise-based cardiac rehabilitation on patients undergoing PCI published in domestic and foreign databases such as PubMed, Web of Science, Embase, Cochrane Library, China Knowledge Network (CNKI), and VIP until December 2023. Studies retrieved were screened, and meta-analysis was extracted. The quality of the literature was evaluated; meta-analysis was carried out by RevMan5.4 software (Cochrane Collaboration, Oxford, UK). Results: A total of 1073 sufferers undergoing PCI were included in 11 literatures. Meta-analysis displayed that cardiogenic mortality [risk ratio (RR) = 0.23, 95% confidence interval (CI) (0.08, 0.64)], coronary restenosis rate [RR = 0.59, 95% CI (0.41, 0.87)], revascularization rate [RR = 0.58, 95% CI (0.43,  0.79)], incidence of recurrent angina pectoris [RR = 0.41, 95% CI (0.27, 0.62)], and late lumen loss [RR = –0.60, 95% CI (–0.98, –0.23)] in the trial group, were lower than those in the control group (p < 0.05). No significant difference was found in the recurrence rate of myocardial infarction between the test group and the control group [RR = 0.52, 95% CI (0.22, 1.25)]. Conclusion: Exercise-based cardiac rehabilitation therapy can effectively reduce the risk of major adverse cardio-cerebrovascular events, such as cardiogenic death and coronary restenosis after PCI; it reduces the late lumen loss of the stent coronary segment and has no obvious effect on the recurrence of myocardial infarction. However, this therapy tends to reduce the recurrence rate of myocardial infarction.
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以运动为基础的心脏康复对经皮冠状动脉介入治疗患者的影响:系统回顾与元分析
研究目的本研究旨在系统分析以运动为基础的心脏康复对经皮冠状动脉介入治疗(PCI)患者的影响。研究方法检索截至 2023 年 12 月在 PubMed、Web of Science、Embase、Cochrane Library、中国知网(CNKI)、VIP 等国内外数据库中发表的关于运动性心脏康复对 PCI 患者影响的原创性研究。对检索到的研究进行筛选,并提取荟萃分析。对文献质量进行评估;采用RevMan5.4软件(Cochrane Collaboration,英国牛津)进行荟萃分析。结果:11篇文献共纳入了1073名接受PCI治疗的患者。Meta 分析显示,心源性死亡率[风险比 (RR) = 0.23,95% 置信区间 (CI) (0.08, 0.64)]、冠状动脉再狭窄率[RR = 0.59,95% CI (0.41, 0.87)]、血运重建率[RR = 0.58,95% CI (0.43, 0.79)]、复发性心绞痛发生率[RR = 0.41, 95% CI (0.27, 0.62)]和晚期管腔缺损率[RR = -0.60, 95% CI (-0.98, -0.23)]均低于对照组(P < 0.05)。试验组与对照组的心肌梗死复发率无明显差异[RR = 0.52,95% CI (0.22,1.25)]。结论以运动为基础的心脏康复治疗能有效降低 PCI 术后心源性死亡和冠脉再狭窄等主要心脑血管不良事件的风险;能减少支架冠脉段的晚期管腔损失,对心肌梗死的复发无明显影响。不过,这种疗法往往会降低心肌梗死的复发率。
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