Author/Authors :
Sadeghi, Masoumeh Cardiac Rehabilitation Research Center - Cardiovascular Research Institute - Isfahan University of Medical Sciences, Isfahan, Iran , Khosravi-Broujeni, Hossein School of Medicine and Menzies Health Institute - Griffith University, Southport, Queensland, Australia , Salehi-Abarghouei, Amin Department of Nutrition - School of Health - Shahid Sadoughi University of Medical Sciences, Yazd, Iran , Heidari, Ramin Isfahan Cardiovascular Research Center - Cardiovascular Research Institute - Isfahan University of Medical Sciences, Isfahan, Iran , Masoumi, Gholamreza Cardiac Rehabilitation Research Center - Cardiovascular Research Institute - Isfahan University of Medical Sciences, Isfahan, Iran , Roohafza, Hamidreza Psychosomatic Research Center - Isfahan University of Medical Sciences, Isfahan, Iran
Abstract :
BACKGROUND: This systematic review and meta-analysis aimed to assess the effect of cardiac
rehabilitation (CR) on serum C-reactive protein (CRP) as an indicator of the inflammatory state
and predictor of recurrent cardiovascular events.
METHODS: PubMed, SCOPUS, Cochrane library, and Google Scholar databases were searched
up to January 2014 for original articles which investigated the effect of CR on CRP among adult
patients with previous cardiovascular events. The random effects model was used to assess the
overall effect of CR on the variation in serum CRP levels.
RESULTS: In the present systematic review and meta-analysis, 15 studies were included. The analysis
showed that CR might significantly reduce high-sensitivity CRP (hs-CRP) levels [Difference in means
(DM) = -1.81 mg/l, 95% confidence interval (CI): -2.65, -0.98; P = 0.004). However, the
heterogeneity between studies was significant (Cochran's Q test, P < 0.001, I-squared = 84.9%). To
find the source of variation, the studies were categorized based on study design (quality) and
duration. The negative effect was higher among studies which followed their participants for 3 weeks
or less (DM = -2.75 mg/l, 95% CI: -3.86, -1.64; P < 0.001) compared to studies which investigated
the effect of CR for 3-8 weeks (DM = -0.89 mg/l, 95% CI: -1.35, -0.44; P < 0.001) and those which
lasted more than 8 weeks (DM = -1.71 mg/l, 95% CI: -2.53, -0.89; P < 0.001). There was no evidence
of heterogeneity when the categorization was based on the follow-up period.
CONCLUSION: Both short- and long-term CR have resulted in improvement in serum hs-CRP
levels. CR can be perceived as a beneficial tool to reduce inflammatory markers among patients
with previous cardiac events.
