Exercise and Inflammation in Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomised Trials

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Abstract

Current evidence suggests that chronic inflammation contributes to the development and progression of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95% confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: -0.55 (95% CI: -0.93, -0.16), P= 0.005), fibrinogen (SMD: -0.52 (95% CI: -0.74, -0.29, P= <0.00001), and von Willebrand factor (SMD: -1.57 (95% CI: -2.23, -0.92), P= <0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti-inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti-inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.
Original languageEnglish
JournalJournal of Sports Sciences
Publication statusAccepted/In press - 24 Oct 2019

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Meta-Analysis
Coronary Artery Disease
Exercise
Inflammation
Confidence Intervals
Anti-Inflammatory Agents
Acute-Phase Proteins
von Willebrand Factor
Chemokines
C-Reactive Protein
Sample Size
Fibrinogen
Biomarkers
Cytokines
Research
Population

Keywords

  • Exercise
  • inflammation
  • systematic review
  • meta-analysis
  • coronary artery disease

Cite this

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title = "Exercise and Inflammation in Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomised Trials",
abstract = "Current evidence suggests that chronic inflammation contributes to the development and progression of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95{\%} confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: -0.55 (95{\%} CI: -0.93, -0.16), P= 0.005), fibrinogen (SMD: -0.52 (95{\%} CI: -0.74, -0.29, P= <0.00001), and von Willebrand factor (SMD: -1.57 (95{\%} CI: -2.23, -0.92), P= <0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti-inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti-inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.",
keywords = "Exercise, inflammation, systematic review, meta-analysis, coronary artery disease",
author = "Gareth Thompson and Gareth Davison and Jacqui Crawford and Ciara Hughes",
year = "2019",
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language = "English",
journal = "Journal of Sports Sciences",
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T1 - Exercise and Inflammation in Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomised Trials

AU - Thompson, Gareth

AU - Davison, Gareth

AU - Crawford, Jacqui

AU - Hughes, Ciara

PY - 2019/10/24

Y1 - 2019/10/24

N2 - Current evidence suggests that chronic inflammation contributes to the development and progression of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95% confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: -0.55 (95% CI: -0.93, -0.16), P= 0.005), fibrinogen (SMD: -0.52 (95% CI: -0.74, -0.29, P= <0.00001), and von Willebrand factor (SMD: -1.57 (95% CI: -2.23, -0.92), P= <0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti-inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti-inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.

AB - Current evidence suggests that chronic inflammation contributes to the development and progression of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95% confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: -0.55 (95% CI: -0.93, -0.16), P= 0.005), fibrinogen (SMD: -0.52 (95% CI: -0.74, -0.29, P= <0.00001), and von Willebrand factor (SMD: -1.57 (95% CI: -2.23, -0.92), P= <0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti-inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti-inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.

KW - Exercise

KW - inflammation

KW - systematic review

KW - meta-analysis

KW - coronary artery disease

M3 - Article

JO - Journal of Sports Sciences

JF - Journal of Sports Sciences

SN - 0264-0414

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