ECSS Paris 2023: OP-MH48
INTRODUCTION: Exercise-based cardiac rehabilitation (CR) is a cornerstone in secondary prevention for coronary artery disease (CAD). While aerobic training (AT) has long been established as the gold standard in rehabilitation, resistance training (RT) has been underutilized in clinical practice due to safety concerns. This study systematically evaluates the efficacy and safety of RT in improving cardiorespiratory fitness, cardiac remodeling, and endothelial function in CAD patients. METHODS: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases for randomized controlled trials (RCTs) comparing RT or combined RT and AT with routine care (UC) or AT in adults with CAD. Primary outcomes included peak oxygen uptake (VO2peak), with secondary outcomes being left ventricular ejection fraction (LVEF) and flow-mediated dilation (FMD). Statistical analysis was performed using R software, with effect sizes reported as standardized mean differences (SMD) or mean differences (MD). RESULTS: A total of 27 RCTs involving 2,423 patients were included. Meta-analysis revealed significant improvements in VO2peak (SMD = 0.62, 95% CI: 0.45 to 0.79, P < 0.001), LVEF (MD = 3.85%, 95% CI: 2.14% to 5.56%, P < 0.001), and FMD (MD = 2.45%, 95% CI: 1.12% to 3.78%, P = 0.002) for RT interventions compared to controls. Subgroup analysis showed the most significant benefit for combined training versus routine care (SMD = 0.88, P < 0.001), with an additive effect when combined with AT (SMD = 0.35, P = 0.003). No serious adverse events related to RT were reported. CONCLUSION: RT, especially when combined with AT, is a safe and effective strategy to enhance cardiorespiratory fitness, cardiac function, and endothelial health in CAD patients. These findings support the inclusion of RT in routine cardiac rehabilitation programs.
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