1. Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction
- Author
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Dorairaj Prabhakaran, Ambalam M. Chandrasekaran, Kalpana Singh, Bishav Mohan, Kaushik Chattopadhyay, Davinder S. Chadha, Prakash C. Negi, Prabhavathi Bhat, Kanchanahalli S. Sadananda, Vamadevan S. Ajay, Kavita Singh, Pradeep A. Praveen, Raji Devarajan, Dimple Kondal, Divya Soni, Poppy Mallinson, Subhash C. Manchanda, Kushal Madan, Alun D. Hughes, Nishi Chathurvedi, Ian Roberts, Shah Ebrahim, Kolli S. Reddy, Nikhil Tandon, Stuart Pocock, Ambuj Roy, Sanjay Kinra, Subhash Chand Manchanda, Ajay Vamadevan S, Kolli Srinath Reddy, Deepak Bhatnagar, Vivek Chaturvedi, Pablo Perel, Neil Poulter, S. Harikrishnan, Ravindra M. Pandey, Amitava Banerjee, Paramjit Gill, Davinder Singh Chadha, Neil Bardoloi, Prakash Chand Negi, Sanjeev Asotra, Prabhavati Bhat, Manjunath C. Nanjappa, M.R. Prasad, Raghava Sarma, K.U. Natrajan, Srikumar Swaminathan, Ravindra K. Tongia, S. Natarajan, Bhaskara Rao, Calambur Narasimhan, Jabir Abdullakutty, Srinivas Mallya, Anil R. Jain, Sudhir R. Naik, Nagraj Desai, Sunil Kumar, Shankar Patil, Satish Patil, Sharad Chandra, and Nagamalesh U. Madappa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Myocardial Infarction ,India ,acute myocardial infarction ,030204 cardiovascular system & hematology ,Article ,law.invention ,rehabilitation ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Exercise ,Rehabilitation ,Cardiac Rehabilitation ,business.industry ,EQ-5D-5L, European Quality of Life–5 Dimensions–5 Level ,Yoga ,Hazard ratio ,Middle Aged ,medicine.disease ,humanities ,Emergency medicine ,Patient Compliance ,Female ,Cardiology and Cardiovascular Medicine ,business ,Yoga-CaRe, yoga-based cardiac rehabilitation ,Mace ,coronary artery disease ,secondary prevention - Abstract
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)., Central Illustration
- Published
- 2020