Document Detail

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH).
MedLine Citation:
PMID:  14729656     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the effect of exercise training on survival in patients with heart failure due to left ventricular systolic dysfunction.
DESIGN: Collaborative meta-analysis. Inclusion criteria Randomised parallel group controlled trials of exercise training for at least eight weeks with individual patient data on survival for at least three months. Studies reviewed Nine datasets, totalling 801 patients: 395 received exercise training and 406 were controls.
MAIN OUTCOME MEASURE: Death from all causes.
RESULTS: During a mean (SD) follow up of 705 (729) days there were 88 (22%) deaths in the exercise arm and 105 (26%) in the control arm. Exercise training significantly reduced mortality (hazard ratio 0.65, 95% confidence interval, 0.46 to 0.92; log rank chi(2) = 5.9; P = 0.015). The secondary end point of death or admission to hospital was also reduced (0.72, 0.56 to 0.93; log rank chi(2) = 6.4; P = 0.011). No statistically significant subgroup specific treatment effect was observed.
CONCLUSION: Meta-analysis of randomised trials to date gives no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous, and indeed there is clear evidence of an overall reduction in mortality. Further research should focus on optimising exercise programmes and identifying appropriate patient groups to target.
M F Piepoli; C Davos; D P Francis; A J S Coats;
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2004-01-16
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  328     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-23     Completed Date:  2004-02-26     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  189     Citation Subset:  AIM; IM    
Cardiac Medicine, Royal Brompton Hospital, Imperial College of Science Technology and Medicine, London.
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MeSH Terms
Exercise Therapy*
Heart Failure / mortality,  rehabilitation*
Prospective Studies
Randomized Controlled Trials as Topic
Risk Factors
Survival Analysis
Comment In:
BMJ. 2004 Mar 20;328(7441):711; author reply 711   [PMID:  15031255 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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