HF-ACTION
Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 2,331 patients with heart failure and reduced ejection fraction, a supervised aerobic exercise-training programme did not significantly reduce all-cause mortality or hospitalisation compared with usual care.
N
2 331
Schéma
Randomised controlled trial, median follow-up 30 months
Critère
All-cause mortality or all-cause hospitalisation
Pertinence
2
Résultat65 % vs 68 % (HR 0.93; 95 % CI 0.84–1.02; p=0.13); prespecified adjusted HR 0.89 (95 % CI 0.81–0.99; p=0.03). No excess of adverse events.
O'Connor CM, Whellan DJ, Lee KL, et al. JAMA. 2009;301(14):1439-1450. 10.1001/jama.2009.454
Discussion et critique
The unadjusted primary endpoint was neutral and adherence fell steadily, so it arguably tested exercise prescription rather than exercise itself. It is the only adequately powered outcome trial of training in heart failure, established its safety, and underpins the class-I recommendation for exercise training.