CARDIAC REHABILITATION AFTER MYOCARDIAL-INFARCTION - COMBINED EXPERIENCE OF RANDOMIZED CLINICAL-TRIALS
CARDIAC REHABILITATION AFTER MYOCARDIAL-INFARCTION - COMBINED EXPERIENCE OF RANDOMIZED CLINICAL-TRIALS
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DOI：
10.1001/jama.260.7.945
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发表时间：
1988-08-19
影响因子：
120.7
通讯作者：
RIMM, AA
中科院分区：
文献类型：
--
作者：
OLDRIDGE, NB;GUYATT, GH;RIMM, AA
心肌梗塞后心脏康复的随机临床试验通常表明接受治疗的患者死亡率较低，但只有一项试验具有统计学意义的显着降低。为了克服在心肌梗死后运动和危险因素康复的随机临床试验中，在少数患者中无法检测出微小但具有临床意义的死亡率益处的问题，我们对包括 4347 名患者（对照；2145 名患者；康复，2202 名患者）的 10 项随机临床试验的综合结果进行了荟萃分析。康复组全因死亡的汇总比值比为 0.76（95% 置信区间，0.63 至 0.92），心血管死亡的汇总比值比为 0.75（95% 置信区间，0.62 至 0.93），显着低于对照组，而非致命性复发性心肌梗死则无显着差异。这些结果表明，对于适当选择的患者，综合心脏康复对死亡率有有益影响，但对非致命性复发性心肌梗死没有影响。
Randomized clinical trials of cardiac rehabilitation following myocardial infarction have typically demonstrated a lower mortality in treated patients, but with a statistically significant reduction in only one trial. To overcome the problem of not being able to detect small but clinically important benefits in mortality in randomized clinical trials of exercise and risk factor rehabilitation after myocardial infarction with small numbers of patients, we carried out a meta-analysis on the combined results of ten randomized clinical trials that included 4347 patients (control; 2145 patients; rehabilitation, 2202 patients). The pooled odds ratios of 0.76 (95% confidence intervals, 0.63 to 0.92) for all-cause death and of 0.75 (95% confidence intervals. 0.62 to 0.93) for cardiovascular death were significantly lower in the rehabilitation group than in the control group, with no significant difference for nonfatal recurrent myocardial infarction. These results suggest that, for appropriately selected patients, comprehensive cardiac rehabilitation has a beneficial effect on mortality but not on nonfatal recurrent myocardial infarction.