Impact of activity trackers on secondary prevention in patients with coronary artery disease: a systematic review and meta-analysis (Preprint)

Abstract

BACKGROUND Ischemic heart disease (IHD) is related to high rates of morbidity and mortality among cardiovascular diseases (CVD). Activity trackers have been used in cardiac rehabilitation (CR) in the last years. However, their effectiveness to influence outcomes after IHD is debated. OBJECTIVE This review summarizes the latest data of impact of activity trackers on CVD risk and outcomes. METHODS Articles from 1986 to 2020 in English were searched by electronic databases (PubMed, Cochrane Library, Embase). Inclusion criteria were: randomized controlled trials of IHD secondary prevention using an activity tracker which include at least peak oxygen consumption (VO2), major adverse cardiovascular events (MACE), quality of life (QoL), LDL-cholesterol (LDL-C) as outcomes. Meta-analysis and qualitative analysis were performed. RESULTS After removing duplicates, 604 articles were included and the screening identified a total of 11 articles. Compared to control groups, intervention groups with activity trackers significantly increased peak VO2 (mean difference 1.54; 95% CI [0.50–2.57]; P=.004) and decreased MACE (risk ratio 0.51; 95% CI [0.31–0.86]; P=.01). Heterogeneity was low (I2=0%) for MACE and high (I2=51%) for peak VO2. Intervention with an activity tracker also has positive impact on QoL in qualitative analyses. There was no between-group difference in LDL-C. CONCLUSIONS CR using activity trackers has a positive and multi-faceted effect on peak VO2, MACE, and QoL in patients with IHD.