Country access to cardiac health (CATCH) program: improving rehospitalisation rates and length of stay for cardiac rehabilitation using innovative telehealth delivery

Abstract

Introduction: Exercise-based cardiac rehabilitation for patients with coronary artery disease (CAD) significantly improves their outcome. It is unclear however whether aerobic intensive interval training (AIIT) enhances patients’ exercise capacity (peak VO2) more than moderate intensity continuous training (MCT). Previous analyses have been constrained by small sample sizes and a limited focus on clinical parameters. Further, results from previous studies have been contradicted by a recently published large RCT. Method: A meta-analysis was performed comparing AIIT and MCT in their ability to improve patients’ peak VO2 and various cardiovascular risk factors. Results: Ten studies with 472 patients were included for analyses (218 AIIT, 254 MCT). There was no significant publication bias (p: 0.08). Overall, AIIT was associated with a more significant increase in VO2 max when compared with MCT (+1.53 mL/kg/min, 95% CI: 0.35-2.72), although significant heterogeneity was observed among the included studies (I2: 83%, p<0.01).MCThoweverwas associatedwith a more significant decrease in resting heart rate (-1.8/min, 95% CI: 0.71-2.89) and body weight (-0.48kg, 95% CI: 0.15-0.81). Both results were highly consistent among included studies (I2=0%, P=NS). No significant differences were noted in the level of glucose, triglyceride and HDL at the end of exercise program between the two groups. Conclusion: AIIT improves exercise capacity in patients with CAD more than MCT, although MCT was associated with a more significant decline in patients’ resting HR and body weight. The underlying mechanisms and clinical relevance of these results are uncertain, and remain potential focus for future studies.