Cardiac Rehabilitation Effectiveness for Coronary Artery Disease by Clinical Era: Trial Sequential Analysis

dc.contributor.authorOliveros, María-José
dc.contributor.authorSerón, Pamela
dc.contributor.authorBuitrago-García, Diana
dc.contributor.authorGrace, Sherry
dc.date.accessioned2023-02-09T06:28:11Z
dc.date.available2023-02-09T06:28:11Z
dc.date.issued2020-12-01
dc.description.abstractCardiac rehabilitation (CR) is an outpatient model of care for the secondary prevention of cardiovascular disease, which is widely and strongly recommended in international clinical guidelines. The latest update of the Cochrane systematic review on CR for patients with coronary artery disease1 found that CR is effective in preventing cardiovascular death and hospital admissions, but not all-cause mortality, reinfarctions and other complications, as reported in the previous update. This could be due to the inclusion of more recent trials. Thanks to advances in medicine, patients now have access to acute revascularization treatments such as thrombolysis and angioplasty, and therefore achieve better outcomes, such that some have hypothesized that CR may have less impact in the current clinical era2. Although the Cochrane review included a meta-regression which showed no impact of the publication year on the effectiveness,1 some others meta-analyses in the field that have included only recent trials,2,3 have contradicted this finding. In this context, we conducted a secondary analysis of these trials with the aim of examining whether there is sufficient data to determine effectiveness of CR on all-cause and cardiovascular mortality as well as hospitalization, and to test effectiveness over time, using trial sequential analysis (TSA) for the first time. With sequential analysis, it is possible to determine the need for more trials or whether the results are conclusive.4 Such analysis allows the effect to be observed as the participants in the primary studies accumulate even if the optimal sample size has not been reached, adjusting the threshold of statistical significance as the sample size is accumulated. 5en_US
dc.description.sponsorshipThis work was supported by the National Agency for Research and Development (ANID), Chile [FONDECYT Regular 2018, grant number 1181734]en_US
dc.identifier.citationOliveros, María-José et al. (2022). Cardiac Rehabilitation Effectiveness for Coronary Artery Disease by Clinical Era: Trial Sequential Analysis. European Journal of Preventive Cardiology 29(1), e18–21. https://doi.org/10.1093/eurjpc/zwaa110en_US
dc.identifier.issn2047-4881
dc.identifier.issn2047-4873
dc.identifier.urihttps://doi.org/10.1093/eurjpc/zwaa110en_US
dc.identifier.urihttp://hdl.handle.net/10315/40871
dc.language.isoenen_US
dc.publisherEuropean Journal of Preventive Cardiologyen_US
dc.rightsThis is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventive Cardiology following peer review. The version of record Oliveros, María-José et al. (2022). Cardiac Rehabilitation Effectiveness for Coronary Artery Disease by Clinical Era: Trial Sequential Analysis. European Journal of Preventive Cardiology 29(1), e18–21. https://doi.org/10.1093/eurjpc/zwaa110 is available online at: https://academic.oup.com/eurjpc/article/29/1/e18/6013086 or https://doi.org/10.1093/eurjpc/zwaa110.en_US
dc.rights.articlehttps://academic.oup.com/eurjpc/article/29/1/e18/6013086en_US
dc.subjectCardiac rehabilitationen_US
dc.subjectCoronary artery diseaseen_US
dc.titleCardiac Rehabilitation Effectiveness for Coronary Artery Disease by Clinical Era: Trial Sequential Analysisen_US
dc.typeArticleen_US

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