Antoniou Varsamo, Kapreli Eleni, Davos Constantinos H, Batalik Ladislav, Pepera Garyfallia
Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece.
Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
Digit Health. 2024 Mar 25;10:20552076241237661. doi: 10.1177/20552076241237661. eCollection 2024 Jan-Dec.
To systematically review the safety and the long-term mortality and morbidity risk-rates of the remotely-delivered cardiac rehabilitation (RDCR) interventions in coronary heart disease (CHD) patients.
The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42023455471). Five databases (Pubmed, Scopus, Cochrane Central Register of Controlled Trials in the Cochrane Library, Cinahl and Web of Science) were reviewed from January 2012 up to August 2023. Inclusion criteria were: (a) randomized controlled trials, (b) RDCR implementation of at least 12 weeks duration, (c) assessment of safety, rates of serious adverse events (SAEs) and re-hospitalization incidences at endpoints more than 6 months. Three reviewers independently performed data extraction and assessed the risk of bias using the Cochrane Risk of Bias tool.
14 studies were identified involving 2012 participants and a range of RDCR duration between 3 months to 1 year. The incidence rate of exercise-related SAEs was estimated at 1 per 53,770 patient-hours of RDCR exercise. A non-statistically significant reduction in the re-hospitalization rates and the days lost due to hospitalization was noticed in the RDCR groups. There were no exercise-related deaths. The overall study quality was of low risk.
RDCR can act as a safe alternative delivery mode of cardiac rehabilitation (CR). The low long-term rates of reported SAEs and re-hospitalization incidences of the RDCR could enhance the uptake rates of CR interventions. However, further investigation is needed in larger populations and longer assessment points.
系统评价远程心脏康复（RDCR）干预措施在冠心病（CHD）患者中的安全性以及长期死亡率和发病率风险率。
该方案已在国际前瞻性系统评价注册库（CRD42023455471）中注册。检索了2012年1月至2023年8月期间的五个数据库（PubMed、Scopus、Cochrane图书馆中的Cochrane对照试验中心注册库、Cinahl和科学网）。纳入标准为：（a）随机对照试验；（b）实施时间至少为12周的RDCR；（c）在6个月以上的终点评估安全性、严重不良事件（SAE）发生率和再住院发生率。三名研究者独立进行数据提取，并使用Cochrane偏倚风险工具评估偏倚风险。
共纳入14项研究，涉及2012名参与者，RDCR持续时间在3个月至1年之间。RDCR运动相关SAE的发生率估计为每53770患者小时运动1例。RDCR组的再住院率和因住院导致的天数减少无统计学意义。无运动相关死亡。总体研究质量为低风险。
RDCR可作为心脏康复（CR）的一种安全替代实施方式。RDCR报告的SAE长期发生率和再住院发生率较低，可能会提高CR干预措施的采用率。然而，需要在更大规模的人群和更长的评估时间点进行进一步研究。
