Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)

M. F. Correction Piepoli, C. Davos, D. P. Francis, A. J S Coats, R. Belardinelli, A. Purcaro, P. Dubach, J. Myers, P. Giannuzzi, P. L. Temporelli, R. Hambrecht, A. Linke, K. Kiilavuori, H. Leinonen, R. S. McKelvie, K. K. Teo, M. Volterrani, A. Giordano, R. P. Wielenga, M. R P BaselierR. Willenheimer, E. Rydberg, S. Adamopoulos, K. Dickestein, A. Gordon, J. B. Kostis, P. Sellier, J. Toman

Research output: Contribution to journalArticle

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Abstract

Objective: To determine the effect of exercise training on survival in patients with heart failure due to left ventricular systolic dysfunction. Design: Collaborative meta-analysis. Inclusion criteria: Randomised parallel group controlled trials of exercise training for at least eight weeks with individual patient data on survival for at least three months. Studies reviewed: Nine datasets, totalling 801 patients: 395 received exercise training and 406 were controls. Main outcome measure: Death from all causes. Results: During a mean (SD) follow up of 705 (729) days there were 88 (22%) deaths in the exercise arm and 105 (26%) in the control arm. Exercise training significantly reduced mortality (hazard ratio 0.65, 95% confidence interval, 0.46 to 0.92; log rank χ2= 5.9; P = 0.015). The secondary end point of death or admission to hospital was also reduced (0.72, 0.56 to 0.93; log rank χ2= 6.4; P = 0.011). No statistically significant subgroup specific treatment effect was observed. Conclusion: Meta-analysis of randomised trials to date gives no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous, and indeed there is clear evidence of an overall reduction in mortality. Further research should focus on optimising exercise programmes and identifying appropriate patient groups to target.

Original languageEnglish
Pages (from-to)189-192
Number of pages4
JournalBritish Medical Journal
Volume328
Issue number7433
Publication statusPublished - Jan 24 2004

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Meta-Analysis
Heart Failure
Exercise
Survival
Mortality
Left Ventricular Dysfunction
Cause of Death
Outcome Assessment (Health Care)
Confidence Intervals
Education
Research
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Correction Piepoli, M. F., Davos, C., Francis, D. P., Coats, A. J. S., Belardinelli, R., Purcaro, A., ... Toman, J. (2004). Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). British Medical Journal, 328(7433), 189-192.

Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). / Correction Piepoli, M. F.; Davos, C.; Francis, D. P.; Coats, A. J S; Belardinelli, R.; Purcaro, A.; Dubach, P.; Myers, J.; Giannuzzi, P.; Temporelli, P. L.; Hambrecht, R.; Linke, A.; Kiilavuori, K.; Leinonen, H.; McKelvie, R. S.; Teo, K. K.; Volterrani, M.; Giordano, A.; Wielenga, R. P.; Baselier, M. R P; Willenheimer, R.; Rydberg, E.; Adamopoulos, S.; Dickestein, K.; Gordon, A.; Kostis, J. B.; Sellier, P.; Toman, J.

In: British Medical Journal, Vol. 328, No. 7433, 24.01.2004, p. 189-192.

Research output: Contribution to journalArticle

Correction Piepoli, MF, Davos, C, Francis, DP, Coats, AJS, Belardinelli, R, Purcaro, A, Dubach, P, Myers, J, Giannuzzi, P, Temporelli, PL, Hambrecht, R, Linke, A, Kiilavuori, K, Leinonen, H, McKelvie, RS, Teo, KK, Volterrani, M, Giordano, A, Wielenga, RP, Baselier, MRP, Willenheimer, R, Rydberg, E, Adamopoulos, S, Dickestein, K, Gordon, A, Kostis, JB, Sellier, P & Toman, J 2004, 'Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH)', British Medical Journal, vol. 328, no. 7433, pp. 189-192.
Correction Piepoli MF, Davos C, Francis DP, Coats AJS, Belardinelli R, Purcaro A et al. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). British Medical Journal. 2004 Jan 24;328(7433):189-192.
Correction Piepoli, M. F. ; Davos, C. ; Francis, D. P. ; Coats, A. J S ; Belardinelli, R. ; Purcaro, A. ; Dubach, P. ; Myers, J. ; Giannuzzi, P. ; Temporelli, P. L. ; Hambrecht, R. ; Linke, A. ; Kiilavuori, K. ; Leinonen, H. ; McKelvie, R. S. ; Teo, K. K. ; Volterrani, M. ; Giordano, A. ; Wielenga, R. P. ; Baselier, M. R P ; Willenheimer, R. ; Rydberg, E. ; Adamopoulos, S. ; Dickestein, K. ; Gordon, A. ; Kostis, J. B. ; Sellier, P. ; Toman, J. / Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). In: British Medical Journal. 2004 ; Vol. 328, No. 7433. pp. 189-192.
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AU - Correction Piepoli, M. F.

AU - Davos, C.

AU - Francis, D. P.

AU - Coats, A. J S

AU - Belardinelli, R.

AU - Purcaro, A.

AU - Dubach, P.

AU - Myers, J.

AU - Giannuzzi, P.

AU - Temporelli, P. L.

AU - Hambrecht, R.

AU - Linke, A.

AU - Kiilavuori, K.

AU - Leinonen, H.

AU - McKelvie, R. S.

AU - Teo, K. K.

AU - Volterrani, M.

AU - Giordano, A.

AU - Wielenga, R. P.

AU - Baselier, M. R P

AU - Willenheimer, R.

AU - Rydberg, E.

AU - Adamopoulos, S.

AU - Dickestein, K.

AU - Gordon, A.

AU - Kostis, J. B.

AU - Sellier, P.

AU - Toman, J.

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N2 - Objective: To determine the effect of exercise training on survival in patients with heart failure due to left ventricular systolic dysfunction. Design: Collaborative meta-analysis. Inclusion criteria: Randomised parallel group controlled trials of exercise training for at least eight weeks with individual patient data on survival for at least three months. Studies reviewed: Nine datasets, totalling 801 patients: 395 received exercise training and 406 were controls. Main outcome measure: Death from all causes. Results: During a mean (SD) follow up of 705 (729) days there were 88 (22%) deaths in the exercise arm and 105 (26%) in the control arm. Exercise training significantly reduced mortality (hazard ratio 0.65, 95% confidence interval, 0.46 to 0.92; log rank χ2= 5.9; P = 0.015). The secondary end point of death or admission to hospital was also reduced (0.72, 0.56 to 0.93; log rank χ2= 6.4; P = 0.011). No statistically significant subgroup specific treatment effect was observed. Conclusion: Meta-analysis of randomised trials to date gives no evidence that properly supervised medical training programmes for patients with heart failure might be dangerous, and indeed there is clear evidence of an overall reduction in mortality. Further research should focus on optimising exercise programmes and identifying appropriate patient groups to target.

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