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Prehabilitation in Patients Undergoing Cardiac Procedures: A Systematic Review and Meta-Analysis.

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Prehabilitation before cardiac procedures improves functional capacity and recovery, reducing hospital stays and complications like pneumonia. Women appear to benefit most from these interventions.

Keywords:
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Area of Science:

  • Cardiology
  • Rehabilitation Medicine
  • Evidence-Based Medicine

Background:

  • Growing evidence supports prehabilitation (pre-procedure exercise and nutritional programs) for cardiac patients.
  • However, the specific efficacy of different prehabilitation components and patient subgroups remains unclear.
  • This meta-analysis evaluates recent randomized controlled trials (RCTs) to clarify these aspects.

Purpose of the Study:

  • To assess the overall efficacy of prehabilitation on clinical outcomes in cardiac patients using recent RCTs.
  • To identify which prehabilitation interventions are most effective.
  • To determine which patient subgroups experience the greatest benefits from prehabilitation.

Main Methods:

  • Systematic literature search of multiple databases (Medline, Embase, Scopus, etc.) for RCTs up to August 2024.
  • Inclusion of trials comparing prehabilitation with standard care in cardiac patients.
  • Meta-analysis using random-effects models, with screening by two independent reviewers.

Main Results:

  • Forty-four RCTs (3,925 patients) showed prehabilitation improved functional capacity (6-minute walk distance) and recovery.
  • Significant reductions observed in in-hospital length of stay, intensive care unit (ICU) stay, and postprocedural pneumonia.
  • Meta-regression indicated greater benefits in studies with a higher proportion of women; specific component effects were inconsistent.

Conclusions:

  • Prehabilitation before cardiac procedures enhances functional capacity and postprocedural recovery.
  • Women may particularly benefit from prehabilitation interventions.
  • Further multicenter studies are recommended to confirm findings and explore optimal protocols.