AIM: To summarize the current evidence with regard to the effectiveness of nonpharmacological secondary prevention strategies of coronary heart disease (CHD) and to investigate the comparative effectiveness of interventions of different categories, specific intervention components and the effectiveness in patient subgroups. METHODS: A structured search of databases and manual search were conducted. Clinical trials and meta-analyses published between January 2003 and September 2008 were included if they targeted adults with CHD, had a follow-up of at least 12 months, and reported mortality, cardiac events or quality of life. Two researchers assessed eligibility and methodological quality, in which appropriate, pooled effect estimates were calculated and tested in sensitivity analyses. RESULTS: Of 4798 publications 43 met the inclusion criteria. Overall study quality was satisfactory, but only about half of the studies reported mortality. Follow-up duration varied between 12 and 120 months. Despite substantial heterogeneity, there was strong evidence of intervention effectiveness overall. The evidence for exercise and multimodal interventions was more conclusive for reducing mortality, whereas psychosocial interventions seemed to be more effective in improving the quality of life. Rigorous studies investigating dietary and smoking cessation interventions, specific intervention components and important patient subgroups, were scarce. CONCLUSION: Nonpharmacological secondary prevention is safe and effective, with exercise and multimodal interventions reducing mortality most substantially. There is a lack of studies concerning dietary and smoking cessation interventions. In addition, intervention effectiveness in patient subgroups and of intervention components could not be evaluated conclusively. Future research should investigate these issues in rigorous studies with appropriate follow-up duration to improve the current poor risk factor control of CHD patients.
AIM: To summarize the current evidence with regard to the effectiveness of nonpharmacological secondary prevention strategies of coronary heart disease (CHD) and to investigate the comparative effectiveness of interventions of different categories, specific intervention components and the effectiveness in patient subgroups. METHODS: A structured search of databases and manual search were conducted. Clinical trials and meta-analyses published between January 2003 and September 2008 were included if they targeted adults with CHD, had a follow-up of at least 12 months, and reported mortality, cardiac events or quality of life. Two researchers assessed eligibility and methodological quality, in which appropriate, pooled effect estimates were calculated and tested in sensitivity analyses. RESULTS: Of 4798 publications 43 met the inclusion criteria. Overall study quality was satisfactory, but only about half of the studies reported mortality. Follow-up duration varied between 12 and 120 months. Despite substantial heterogeneity, there was strong evidence of intervention effectiveness overall. The evidence for exercise and multimodal interventions was more conclusive for reducing mortality, whereas psychosocial interventions seemed to be more effective in improving the quality of life. Rigorous studies investigating dietary and smoking cessation interventions, specific intervention components and important patient subgroups, were scarce. CONCLUSION: Nonpharmacological secondary prevention is safe and effective, with exercise and multimodal interventions reducing mortality most substantially. There is a lack of studies concerning dietary and smoking cessation interventions. In addition, intervention effectiveness in patient subgroups and of intervention components could not be evaluated conclusively. Future research should investigate these issues in rigorous studies with appropriate follow-up duration to improve the current poor risk factor control of CHD patients.
Authors: T Vromen; R F Spee; J J Kraal; N Peek; M M van Engen-Verheul; R A Kraaijenhagen; H J H Gijsbers; H M C Kemps Journal: Neth Heart J Date: 2013-03 Impact factor: 2.380
Authors: Mariëtte M van Engen-Verheul; Wouter T Gude; Sabine N van der Veer; Hareld M C Kemps; Monique M W Jaspers; Nicolette F de Keizer; Niels Peek Journal: AMIA Annu Symp Proc Date: 2015-11-05
Authors: Mariëtte M van Engen-Verheul; Nicolette F de Keizer; Sabine N van der Veer; Hareld M C Kemps; Wilma J M Scholte op Reimer; Monique W M Jaspers; Niels Peek Journal: Implement Sci Date: 2014-12-31 Impact factor: 7.327
Authors: Eric C Stecker; Carmen Teodorescu; Kyndaron Reinier; Audrey Uy-Evanado; Ronald Mariani; Harpriya Chugh; Karen Gunson; Jonathan Jui; Sumeet S Chugh Journal: J Am Heart Assoc Date: 2014-10-06 Impact factor: 5.501
Authors: Jos J Kraal; Niels Peek; M Elske van den Akker-Van Marle; Hareld M C Kemps Journal: BMC Cardiovasc Disord Date: 2013-10-08 Impact factor: 2.298