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Could exercise-based rehabilitation be personalised?

Heart Failure 2016 Congress News

Rod Taylor (University of Exeter Medical School, the UK)

Late Breaking Trials III: Focus on trial updates, registries and meta-analyses; 23 May, 08:30–10:00; Paris

Tomorrow, the question of whether exercise-based rehabilitation could be targeted to specific heart failure patient groups and thus help rationalise healthcare resources will be answered when international researchers present the results of their individual patient data meta-analysis.

Rod Taylor (University of Exeter Medical School, the UK) and colleagues previously conducted a trial-level meta-analysis of exercise-based rehabilitation, which showed improvements in patient quality of life and reductions in hospital admissions but no clear evidence of an all-cause mortality benefit. [1]

However, Prof. Taylor told Heart Failure Congress News that “this trial level analysis study may have lacked statistical power and had to deal with studies of differing follow up duration”.

He explained that, with an individual patient data meta-analysis, the original patient anonymised data is, in essence, reconstructed and reorganised, and analysed as if one mega-trial.

Prof. Taylor and an international team of collaborators have collated data from 20 trials, totalling more than 4000 heart failure patients who underwent ≥3 weeks of exercise training and had reported outcomes at ≥6 months.

Prof. Taylor said that this is necessary as one of the “big challenges” in cardiology today is that, although exercise-based rehabilitation offers patient benefits and is a Class I recommendation of the European Society of Cardiology guidelines, only around one in five heart failure patients across Europe currently receive it.

Prof. Taylor observed: “We wanted to address the question of whether we should be prescribing rehabilitation to all our heart failure patients or only a subgroup of patients.”

It remains unclear whether particular patient subgroups with heart failure would benefit more or less from exercise-based rehabilitation than others, and therefore healthcare resources could be targeted more efficiently.

Professor Taylor said that he and his ExTraMATCH II collaborators “are excited to be able bring together this data set, which offers a level of statistical precision that we haven’t previously had in our trial-level meta-analysis to address this subgroup question” to provide answers for patients, clinicians and policy makers alike.


  1. Taylor RS, Sagar VA, Davies EJ et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev 2014; 4: CD003331.

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