一个概述的随机试验的康复与运动,心肌梗塞后的心肌梗塞
G T O'Connor1, J E Buring, S Yusuf
1Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Circulation
|August 1, 1989
概括
通过运动进行心脏康复,可显著降低心脏病总死亡率,心血管死亡率和心肌梗塞 (MI) 后致命的复发性心脏病发作. 这项对22项试验的元分析显示,整体死亡率减少了20%,突出显示了综合性心脏恢复计划的好处.
科学领域:
- 心脏病学 心脏病学
- 康复医学 康复医学 康复医学
- 证据综合 证据综合
背景情况:
- 心肌梗塞 (MI) 幸存者经常从康复中受益,但随机试验的综合证据需要综合.
- 个人对心脏病发作后心脏康复的试验显示出不同的结果,只有一个达到传统的统计学意义.
研究的目的:
- 进行所有随机试验的概述,评估心肌梗塞后运动康复的有效性.
- 确定心脏康复对总死亡率,心血管死亡率,突然死亡和再发病的综合影响.
主要方法:
- 进行了22项随机试验的概述,涉及4,554名患者.
- 几率比率 (OR) 和95%置信区间 (95% CI) 计算了多个终点和随访持续时间的综合试验数据.
主要成果:
- 在3年后,康复显著降低了总死亡率 (OR=0.80),心血管死亡率 (OR=0.78) 和致命的复发性心脏病发作 (OR=0.75).
- 一年后,突然死亡风险显著降低 (OR=0.63),趋势表明受益时间长达3年.
- 在康复组和对照组之间,没有观察到非致命的复发率的显著差异.
结论:
- 心脏康复包括运动在内,在心肌梗塞后长期减少死亡率和致命的复发性心脏病发作的显著好处.
- 这些发现支持整体死亡率减少20%,主要是由于心血管死亡率下降和致命的再发作.
- 需要进一步进行大规模的随机试验,以最终分离运动组成部分与心脏康复其他方面的影响.
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