Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: A systematic review and meta-analysis

Zheng, Xianghui; Yang, Zheng; Ma, Jing; Zhang, Maomao; Zhang, Yongxiang; Liu, Xianglan; Chen, Liangqi; Yang, Qingyuan; Sun, Yong; Wu, Jiarui; Yu, Bo

doi:10.1016/j.hrtlng.2018.09.011

Cited by 77 publications

(54 citation statements)

References 52 publications

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“…17 Subsequently, a 2019 metaanalysis reported exercise to be effective in reducing anxiety and depression following myocardial infarction. 18 However, in a review of prospective cohort studies, 19 people with depression were four times less likely to participate in CR and seven times more likely to drop out. A 2019 systematic review (14 RCTs, N=1739) of CR for people following acute coronary syndrome, published when this paper was being prepared for submission, included eight studies in a meta-analysis and concluded that there were clinically important positive effects on two 36-Item Short Form Survey Instrument (SF-36) domains at 6 months (role physical and general health) and one domain at 12 months (physical function).…”

Section: Introductionmentioning

confidence: 99%

Does contemporary exercise-based cardiac rehabilitation improve quality of life for people with coronary artery disease? A systematic review and meta-analysis

et al. 2020

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ObjectivesTo determine the effect of contemporary exercise-based cardiac rehabilitation on generic and disease-specific health related quality of life for people with coronary artery disease.DesignSystematic review and meta-analysis.Study eligibility criteriaRandomised controlled trials testing exercise-based cardiac rehabilitation versus no exercise control that recruited after 31 December 1999. On 30 July 2019, we searched the Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), Embase (Ovid) and CINAHL (EBSCO) databases.Study appraisal and synthesisStudies were screened for inclusion by two independent reviewers. Risk of bias was assessed using the Cochrane risk of bias tool. Data were reported as pooled means (95% CI for between-group difference.ResultsWe identified 24 studies (n=4890). We performed meta-analyses for 15 short-term and 9 medium-term outcomes (36-Item Short Form Survey Instrument (SF-36), EuroQol-5D (EQ-5D) and MacNew, a cardiac-specific outcome). Six short-term and five medium-term SF-36 domains statistically favoured exercise-based cardiac rehabilitation. Only for two short-term SF-36 outcomes, ‘physical function’ (mean difference 12.0, 95% CI 4.4 to 19.6) and ‘role physical’ (mean difference 16.9, 95% CI 2.4 to 31.3), did the benefit appear to be clinically important. Meta-analyses of the short-term SF-36 physical and mental component scores, EQ-5D and MacNew and the medium-term SF-36 physical component score, did not show statistically significant benefits. Only two studies had a low risk of bias (n=463 participants).Conclusions and implications of key findingsThere is some evidence of a short-term benefit of contemporary exercise-based cardiac rehabilitation on quality of life for people with coronary artery disease. However, the contemporary data presented in this review are insufficient to support its routine use.

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Section: Introductionmentioning

confidence: 99%

Does contemporary exercise-based cardiac rehabilitation improve quality of life for people with coronary artery disease? A systematic review and meta-analysis

et al. 2020

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“…A number of risk factors contribute to the increased risk of CHD including hypertension, hyperlipidemia, aging, and diabetes (Saygin et al, 2018). According to the 2016 World Health Organization global disease assessment report, cardiovascular diseases (CVDs) have been the leading cause of death in the last 10 years (Zheng et al, 2018). The number of patients with CVD in China has exceeded 290 million; the number Rev.…”

Section: Introductionmentioning

confidence: 99%

Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance

2019

Reviews in Cardiovascular Medicine

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Coronary heart disease is a serious threat to human health. In China, medical care for the population has been focused on therapy with little follow-up of treated patients. The efficacy of therapy; however, is highly dependent on post-therapy recovery. Cardiac rehabilitation can significantly enhance patient physical strength and help delay and prevent the development of coronary atherosclerosis. Although the clinical significance of cardiac rehabilitation has been established, the compliance of patients is generally low. In efforts to improve patient compliance, domestic and foreign researchers have extensively studied and applied treatment models of cardiac rehabilitation according to the specific conditions and cultural background of each country. This study aimed to review the treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance to provide a better perspective of how patients with coronary heart disease can benefit from cardiac rehabilitation.

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“…CR is effective and recommended for CVD patients according to a recent Cochrane review [6]. In addition, some meta-analyses have shown that CR reduces depressive symptoms [7, 8]. Recent CR and prevention guidelines recommend the assessment of depression under the virtue of being a multicomponent intervention and as a risk factor for poor medical outcomes in CVD patients [1, 5, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

To what extent is multi-morbidity associated with new onset depression in patients attending cardiac rehabilitation?

Sever

Doherty

Harrison

et al. 2019

BMC Cardiovasc Disord

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BackgroundDepression is associated with increased mortality and poor prognosis in patients with cardiovascular disease (CVD). However, little is known about the patient characteristics associated with new onset post heart event depressive symptoms, specifically medical comorbidities, among cardiac rehabilitation (CR) participants. Therefore, this paper examines the comorbidity profile and characteristics associated with new onset depressive symptoms in patients attending CR.MethodsAn observational study using the routine practice data of British Heart Foundation National Audit of Cardiac Rehabilitation (NACR) from the last six years between April 2012 and March 2018. Patients with new onset post heart event depression and no previous documented history of depression were selected as the study population. An independent samples t-test and chi square tests were used to compare the association between new onset depressive symptoms and patient variables including demographics, clinical measures and comorbidities. A binary logistic regression was conducted to investigate the predictors of new onset depressive symptoms employing log-likelihood ratio statistic.ResultsThe analyses included 109,055 CR patients with new onset depression measured by Hospital Anxiety and Depression Scale (HADS). At baseline assessment, comorbidity measures associated with new onset depressive symptoms were increased total number of comorbidities and a range of comorbidities - including diabetes, angina, arthritis, chronic back problems, asthma, stroke, anxiety, rheumatism, claudication, osteoporosis, chronic bronchitis and emphysema. After multivariate adjustments were done, at the start of CR, the significant predictors of new onset depressive symptoms were physical inactivity, high HADS anxiety score measurement, increased weight, total number of comorbidities, diabetes, stroke, chronic back problems, being from areas with higher levels of social deprivation, being single, and male.ConclusionThe research findings establish new insights into the association between patient demographic and clinical variables across a range of comorbidities in patients with new onset post heart event depressive symptoms. At the start of CR, patients with new onset depressive symptoms need to be assessed skilfully as they tend to have a complex multi-morbid presentation linked to psychosocial risk factors known to hinder CR engagement.

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Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: A systematic review and meta-analysis

Cited by 77 publications

References 52 publications

Does contemporary exercise-based cardiac rehabilitation improve quality of life for people with coronary artery disease? A systematic review and meta-analysis

Does contemporary exercise-based cardiac rehabilitation improve quality of life for people with coronary artery disease? A systematic review and meta-analysis

Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance

To what extent is multi-morbidity associated with new onset depression in patients attending cardiac rehabilitation?

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