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Meta-analysis finds exercise training reduces hospitalization risk in coronary artery disease patientsModerate exercise training reduces hospitalization risk for heart disease patients

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Key Takeaway
Consider MICT for CAD patients to potentially reduce hospitalization risk, but note limited evidence for VICT.

This systematic review and meta-analysis examined the effects of exercise training of varying intensities and volumes in patients with coronary artery disease, comparing it to usual care or control interventions. The analysis included randomized controlled trials, which supports causal inference for the interventions studied, though specific sample sizes, follow-up duration, and primary outcome were not reported.

The main findings indicate that moderate-intensity continuous training (MICT) significantly lowered the risk of overall hospitalization (RR = 0.66, 95% CI: 0.47-0.95) and cardiovascular hospitalization (RR = 0.66, 95% CI: 0.44-0.99) compared to usual care. Vigorous-intensity continuous training (VICT) was associated with a reduction in cardiovascular hospitalization risk (RR = 0.35, 95% CI: 0.14-0.92), and exercise training in general was reported to reduce the risk of cardiovascular mortality, though specific effect sizes and absolute numbers for these broader outcomes were not provided.

Safety and tolerability data were not reported in the available evidence. A key limitation noted is that the evidence for VICT is limited. The practice relevance suggests MICT may become an effective exercise-based intervention for preventing hospitalizations in this population, but clinicians should note the incomplete reporting of numerical data and exercise protocols when considering these findings for patient management.

Researchers analyzed multiple studies to understand how different types of exercise affect people with coronary artery disease, a condition where blood vessels to the heart become narrowed. They looked at moderate-intensity continuous training (like brisk walking) and vigorous-intensity continuous training (like running), comparing them to usual care without structured exercise programs.

The analysis found that moderate-intensity exercise significantly reduced the risk of both overall hospitalization and heart-related hospitalization. For vigorous exercise, the evidence was more limited but suggested it might also reduce heart-related hospitalization risk. The study didn't report specific numbers about how many people experienced these benefits or whether there were any safety concerns with the exercise programs.

It's important to remember this was a review of existing studies, not a new clinical trial. The evidence for vigorous exercise is particularly limited, meaning we need more research to be confident about its effects. People with heart disease should talk with their doctor before starting any new exercise program to make sure it's safe for their specific situation.

What this means for you:
Moderate exercise may help reduce hospital visits for heart disease patients, but check with your doctor first.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
AIMS: To ascertain the impact of varying exercise intensities and volumes on clinical outcomes of patients with coronary artery disease (CAD) via a systematic review and meta-analysis. METHODS AND RESULTS: This study included randomized controlled trials to evaluate the effects of different intensity levels and volumes of exercise training and control interventions on clinical outcomes in patients with CAD. Data from eight databases were screened, extracted, and assessed for quality by two independent reviewers. Included studies were categorized into subgroups based on exercise intensity and volume. A random-effects model was used to conduct a meta-analysis of different outcomes. To further explore the combined effects, an exploratory network meta-analysis was performed, combining exercise intensity and exercise volume. Exercise training reduces the risk of cardiovascular mortality, overall hospitalization and cardiovascular hospitalization. In subgroup analyses, both moderate-intensity and continuous training significantly reduce the risk of overall hospitalization. Furthermore, the network meta-analysis shows that moderate-intensity continuous training (MICT) significantly lowers the risk of overall hospitalization [(risk ratio (RR) = 0.66, 95% confidence interval (CI): 0.47-0.95), surface under the cumulative ranking curve (SUCRA) = 70.6%] and cardiovascular hospitalization (RR = 0.66, 95% CI: 0.44-0.99, SUCRA = 80.1%) compared with usual care. In contrast to usual care, vigorous-intensity continuous training (VICT) lowers the risk of cardiovascular hospitalization (RR = 0.35, 95% CI: 0.14-0.92, SUCRA = 94.1%). CONCLUSION: MICT significantly reduces the risk of overall hospitalization and cardiovascular hospitalization. Although the evidence is limited, VICT appears to reduce the risk of cardiovascular hospitalization. Consequently, it may become an effective exercise-based intervention for preventing such events. REGISTRATION: PROSPERO: CRD42024519198.
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