TY - JOUR
T1 - Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction
T2 - A Randomized Trial
AU - Yoga-CaRe Trial Investigators
AU - Prabhakaran, Dorairaj
AU - Chandrasekaran, Ambalam M.
AU - Singh, Kalpana
AU - Mohan, Bishav
AU - Chattopadhyay, Kaushik
AU - Chadha, Davinder S.
AU - Negi, Prakash C.
AU - Bhat, Prabhavathi
AU - Sadananda, Kanchanahalli S.
AU - Ajay, Vamadevan S.
AU - Singh, Kavita
AU - Praveen, Pradeep A.
AU - Devarajan, Raji
AU - Kondal, Dimple
AU - Soni, Divya
AU - Mallinson, Poppy
AU - Manchanda, Subhash C.
AU - Madan, Kushal
AU - Hughes, Alun D.
AU - Chathurvedi, Nishi
AU - Roberts, Ian
AU - Ebrahim, Shah
AU - Reddy, Kolli S.
AU - Tandon, Nikhil
AU - Pocock, Stuart
AU - Roy, Ambuj
AU - Kinra, Sanjay
AU - Chand Manchanda, Subhash
AU - Vamadevan S, Ajay
AU - Reddy, Kolli Srinath
AU - Bhatnagar, Deepak
AU - Chaturvedi, Vivek
AU - Perel, Pablo
AU - Poulter, Neil
AU - Harikrishnan, S.
AU - Pandey, Ravindra M.
AU - Banerjee, Amitava
AU - Gill, Paramjit
AU - Chadha, Davinder Singh
AU - Bardoloi, Neil
AU - Chand Negi, Prakash
AU - Asotra, Sanjeev
AU - Bhat, Prabhavati
AU - Nanjappa, Manjunath C.
AU - Prasad, M. R.
AU - Sarma, Raghava
AU - Natrajan, K. U.
AU - Swaminathan, Srikumar
AU - Tongia, Ravindra K.
AU - Natarajan, S.
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020/4/7
Y1 - 2020/4/7
N2 - Background: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). Objectives: This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. Methods: The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were: 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health on the European Quality of Life–5 Dimensions–5 Level visual analogue scale at 12 weeks. Results: MACE occurred in 131 (6.7%) patients in the Yoga-CaRe group and 146 (7.4%) patients in the enhanced standard care group (hazard ratio with Yoga-CaRe: 0.90; 95% confidence interval [CI]: 0.71 to 1.15; p = 0.41). Self-rated health was 77 in Yoga-CaRe and 75.7 in the enhanced standard care group (baseline-adjusted mean difference in favor of Yoga-CaRe: 1.5; 95% CI: 0.5 to 2.5; p = 0.002). The Yoga-CaRe group had greater return to pre-infarct activities, but there was no difference in tobacco cessation or medication adherence between the treatment groups (secondary outcomes). Conclusions: Yoga-CaRe improved self-rated health and return to pre-infarct activities after acute myocardial infarction, but the trial lacked statistical power to show a difference in MACE. Yoga-CaRe may be an option when conventional CR is unavailable or unacceptable to individuals. (A study on effectiveness of YOGA based cardiac rehabilitation programme in India and United Kingdom; CTRI/2012/02/002408).
AB - Background: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). Objectives: This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. Methods: The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were: 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health on the European Quality of Life–5 Dimensions–5 Level visual analogue scale at 12 weeks. Results: MACE occurred in 131 (6.7%) patients in the Yoga-CaRe group and 146 (7.4%) patients in the enhanced standard care group (hazard ratio with Yoga-CaRe: 0.90; 95% confidence interval [CI]: 0.71 to 1.15; p = 0.41). Self-rated health was 77 in Yoga-CaRe and 75.7 in the enhanced standard care group (baseline-adjusted mean difference in favor of Yoga-CaRe: 1.5; 95% CI: 0.5 to 2.5; p = 0.002). The Yoga-CaRe group had greater return to pre-infarct activities, but there was no difference in tobacco cessation or medication adherence between the treatment groups (secondary outcomes). Conclusions: Yoga-CaRe improved self-rated health and return to pre-infarct activities after acute myocardial infarction, but the trial lacked statistical power to show a difference in MACE. Yoga-CaRe may be an option when conventional CR is unavailable or unacceptable to individuals. (A study on effectiveness of YOGA based cardiac rehabilitation programme in India and United Kingdom; CTRI/2012/02/002408).
KW - acute myocardial infarction
KW - cardiac rehabilitation
KW - coronary artery disease
KW - rehabilitation
KW - secondary prevention
KW - yoga
UR - http://www.scopus.com/inward/record.url?scp=85082013261&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.01.050
DO - 10.1016/j.jacc.2020.01.050
M3 - Article
C2 - 32241371
AN - SCOPUS:85082013261
SN - 0735-1097
VL - 75
SP - 1551
EP - 1561
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 13
ER -