Effect of exercise-based cardiac rehabilitation in patients with acute coronary syndrome: a systematic review and meta-analysis

Abstract

Acute Coronary Syndrome (ACS) poses a significant threat to cardiovascular health. This study evaluates the effects of structured exercise cardiac rehabilitation (CR) both center-based and home-based on incidence of major adverse cardiovascular events (MACE) and 6 min Walk Test (6MWT) in ACS patients. Acute Coronary Syndrome (ACS) poses a significant threat to cardiovascular health. This study evaluates the effects of structured exercise cardiac rehabilitation (CR) both center-based and home-based on incidence of major adverse cardiovascular events (MACE) and 6 min Walk Test (6MWT) in ACS patients. Ten RCTs showed that rehabilitation significantly reduced the odds of MACE compared to usual care (OR: 0.16, 95 CI: 0.07-0.38; p = 0.00). In terms of type of rehabilitation, center-based CR had a lower odd of MACE (OR: 0.13) than home-based CR (OR: 0.37), though the difference was not statistically significant (p = 0.24). In terms of follow-up duration, studies with <= 1 year follow-up reported lower MACE odds (OR: 0.10) compared to those > 1 year (OR: 0.28), also not statistically significant (p = 0.33). For functional capacity, analysis of seven studies showed that rehabilitation significantly improved 6MWT performance. Exercise-based rehabilitation led to an average increase of 86.24 m, Home-based rehabilitation showed a smaller gain of 37.63 m, with a significant difference between the two groups (p = 0.04). This meta-analysis provides strong evidence that CR, particularly structured exercise-based programs, significantly reduces the risk of MACE and improves functional capacity in patients with cardiovascular disease.