HF-ACTION
Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training
Paziente / Popolazione Intervento / Esposizione Confronto Esito
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
2331
Disegno
Randomised controlled trial, median follow-up 30 months
Esito
All-cause mortality or all-cause hospitalisation
Rilevanza
2
Risultato65 % 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
Discussione e critica
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.