Medicina oral, patologia oral y cirugia bucal · 2017
Sclerotherapy for the recurrent granulomatous epulis with pingyangmycin.
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Shen Ting, Shi Cheng, Li Guanghe, Jiang Yumei, Li Dejie, Qian Lei, Ma Congying, Wang Guangyu, Zheng Liang, Shen Yuqin
Аннотация
BACKGROUND: Cardiac rehabilitation (CR) may benefit patients with atrial fibrillation (AF) in areas such as exercise capacity. However, evidence regarding its impact on AF recurrence, a key clinical outcome, remains inconsistent. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of CR on AF recurrence, all-cause mortality, hospitalization, and exercise capacity in patients with AF.
METHODS: We systematically searched the Cochrane Library, PubMed, and Embase from January 1, 1980, to April 20, 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A total of 1,550 patients from 11 RCTs were included in the meta-analysis based on the predefined inclusion and exclusion criteria.
RESULTS: Pooled analysis demonstrated a significant reduction in AF recurrence among patients receiving CR compared with controls (risk ratio (RR) 0.77, 95% confidence interval (CI) [0.67-0.89], p = 0.0003, I 2 = 20%). However, this effect was not statistically significant in the exploratory subgroup of patients post-ablation (RR 0.86, 95% CI [0.69-1.07], p = 0.17, I 2 = 0%). Exercise capacity, measured via the 6-minute walking test, significantly improved (weighted mean difference (WMD) 32.22, 95% CI [21.22-43.23], p < 0.00001, I 2 = 0%). No significant differences were observed in all-cause mortality (RR 1.04, 95% CI [0.74-1.46], p = 0.81, I 2 = 0%), hospitalization rates (RR 1.00, 95% CI [0.85-1.19], p = 0.97, I 2 = 0%), or the composite outcome of mortality and hospitalization (RR 1.01, 95% CI [0.90-1.14], p = 0.83, I 2 = 0%).
CONCLUSIONS: CR is associated with a reduction in AF recurrence in the overall AF population, though this benefit was not observed in the exploratory subgroup of patients post-ablation. It significantly improves exercise capacity but does not appear to affect mortality or hospitalization rates. Further high-quality randomized trials are needed to evaluate the benefits and potential risks of CR across different types of AF.
METHODS: We systematically searched the Cochrane Library, PubMed, and Embase from January 1, 1980, to April 20, 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A total of 1,550 patients from 11 RCTs were included in the meta-analysis based on the predefined inclusion and exclusion criteria.
RESULTS: Pooled analysis demonstrated a significant reduction in AF recurrence among patients receiving CR compared with controls (risk ratio (RR) 0.77, 95% confidence interval (CI) [0.67-0.89], p = 0.0003, I 2 = 20%). However, this effect was not statistically significant in the exploratory subgroup of patients post-ablation (RR 0.86, 95% CI [0.69-1.07], p = 0.17, I 2 = 0%). Exercise capacity, measured via the 6-minute walking test, significantly improved (weighted mean difference (WMD) 32.22, 95% CI [21.22-43.23], p < 0.00001, I 2 = 0%). No significant differences were observed in all-cause mortality (RR 1.04, 95% CI [0.74-1.46], p = 0.81, I 2 = 0%), hospitalization rates (RR 1.00, 95% CI [0.85-1.19], p = 0.97, I 2 = 0%), or the composite outcome of mortality and hospitalization (RR 1.01, 95% CI [0.90-1.14], p = 0.83, I 2 = 0%).
CONCLUSIONS: CR is associated with a reduction in AF recurrence in the overall AF population, though this benefit was not observed in the exploratory subgroup of patients post-ablation. It significantly improves exercise capacity but does not appear to affect mortality or hospitalization rates. Further high-quality randomized trials are needed to evaluate the benefits and potential risks of CR across different types of AF.