Effectiveness of endurance exercise training in patients with coronary artery disease: A meta-analysis of randomised controlled trials

Background: Exercise interventions apparently reduce the risks of and prevent coronary artery disease (CAD). Developing an exercise intervention for patients with CAD is a rapidly expanding focus worldwide. The results of previous studies are inconsistent and difficult to interpret across various types of exercise programme. Aim: This study aimed to update prior systemic reviews and meta-analyses in order to determine the overall effects of endurance exercise training on patients with CAD. Methods: The databases (PubMed, Medline, CINAHL, EMBASE and Cochrane Library) were searched for the interventions published between January 1, 2000, and May 31, 2015. Comprehensive meta-analysis software was used to evaluate the heterogeneity of the selected studies and to calculate mean differences (MDS) while considering effect size. Results: A total of 18 studies with 1286 participants were included. Endurance exercise interventions at a moderate to high training intensity significantly reduced resting systolic blood pressure (MD: -3.8 mmHg, p = 0.01) and low-density lipoprotein cholesterol (MD: -5.5 mg/dL, p = 0.02), and increased high-density lipoprotein cholesterol (MD: 3.8 mg/dL, p < 0.001). There were also significant positive changes in peak oxygen consumption (MD: 3.47 mL/kg/min, p < 0.001) and left ventricular ejection fraction (MD: 2.6%, p = 0.03) after the interventions. Subgroup analysis results revealed that exercise interventions of 60-90 minutes per week with a programme duration of >12 weeks had beneficial effects on functional capacity, cardiac function and a number of cardiovascular risk factors. Conclusions: Endurance exercise training has a positive effect on major modifiable cardiovascular risk factors and functional capacity. Nurses can develop endurance exercise recommendations for incorporation into care plans of clinically stable CAD patients following an acute cardiac event or revascularisation procedure.