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Table 1 Study characteristics

From: Sex differences in the physiological responses to cardiac rehabilitation: a systematic review

Study ID

Population description

Total number of participants in relevant cohort

Type of CR

Length of CR

Completion and/or Adherence

(sex presented separately where available)

Quality Assessment (out of 12)

Statistics for relevant comparisons

 

Adams 1999 [102]

Patients with CABG, MI, PTCA, cardiomyopathy, and stable angina

n = 61 (46 men, 15 women)

HIIT & Aerobic

8 Weeks

CR Completion 100%

11

ANOVA

 

Ades 1992 [27]

All patients (hospitalized from AMI or CABG) interviewed were candidates for participation in cardiac rehabilitation

n = 57

(39 men, 18 women)

Aerobic

12 Weeks

CR Completion 95% 37/39 men, 94% 17/18 women

11

t-test

 

Anjo 2014 [53]

Patients with CAD who attended a cardiac rehab program after an ACS or elective PCI

n = 386

(301 men, 85 women)

Aerobic and Strength

8–12 Weeks

> 80% sessions attended

11

t-test

 

Antunes-Correa 2010 [28]

Patients with clinically stable HF, aged between 40 to 70 years, in NYHA functional class II to III and with an ejection fraction < 40%

n = 21

(12 men, 9 women)

Aerobic and Strength

16 Weeks

85–100% of sessions attended.

12

ANOVA

 

Araya-Ramirez 2021 [64]

Cardiac patients enrolled in a university-based CR program

n = 311 (237 men, 74 women)

Aerobic

12 Weeks

92% adherence for men and women

12

ANCOVA

 

Balady 1996 [54]

Patients experiencing MI, CABG, or PTCA within 6 months of program

n = 778 (558 men, 220 women)

Aerobic with Strength at some centers.

10 ± 2 weeks

CR completion: 33% 182/558 men, 28% 61/220 women; 83% adherence rate for men and women

12

t-test

 

Baranyi 2022 [103]

Patients with acute MI

n = 56 (45 men, 11 women)

Not described

4 weeks

CR completion: 100%

10

ANCOVA

 

Bellet 2015 [65]

Patients with a diagnosis of MI, angina, controlled arrhythmia, CAD or PCI, CABG, or experienced cardiac valve surgery, defibrillator, or pacemaker implantation. Patients were divided into a fast-track CR or a traditional CR program

n = 197 (130 men, 67 women) Fast Track CR, n = 423 (332 men, 91 women) Traditional CR

Aerobic and Strength

6 Weeks

CR completion: 58% 115/197 fast track CR patients and 60% 254/423 traditional CR patients.

11

ANOVA

 

Braga 2021 [96]

Patients were diagnosed with ACS

n = 731

(633 men, 98 women)

Aerobic and Strength

Up to 12 Weeks

> 50% sessions attended

10

t-test

 

Branco 2016 [55]

Patients diagnosed with CAD who have been referred to CR

n = 1399

(1068 men, 331 women)

Aerobic and Strength

8–12 Weeks

CR completion: 83% 886/1068 men, 72% 238/331 women

12

t-test

 

Brawner 2022 [61]

Patients were attending CR for CABG, MI, PCI, valve replacement, heart failure

n = 4455 (2829 male, 1626 female)

Aerobic

≤ 18 weeks

9–36 visits 1–3 days/week

11

ANOVA

 

Brochu 2000 [29]

Patients with AMI, CABG, unstable angina, and CHF

n = 82

(59 men, 23 women)

Aerobic and Strength

12 Weeks

CR completion: 100%

12

ANOVA

 

Calvo-Lopez 2023 [62]

Patients with acute MI in last 3 months

n = 50 (42 men, 8 women)

Home-based (Aerobic and Strength)

8 Weeks

CR completion: 100%

Adherence was 82.9% men, 95.6% women

11

t-test between deltas

 

Caminiti 2022 [104]

Patients with CAD

n = 55 (35 men, 20women)

Aerobic and Strength

12 Weeks

CR completion: 95%

Adherence was 89.4% men and 86.1% women

12

ANOVA

 

Candelaria 2020 [66]

Patients were eligible if they were attending CR for CAD, arrhythmia, heart failure and implantable devices

n = 849

(604 men, 245 women)

Aerobic and Strength

6–12 Weeks

CR completion: 71% 426/604 men, 74% 181/245 women

10

t-test

 

Cannistra 1992 [56]

Patients with heart disease: MI +- revascularization, CABG, coronary angioplasty, or angina pectoris

n = 225

(174 men, 51 women)

Aerobic

12 Weeks

CR completion: 63% 110/174 men, 51% 26/51 women. Adherence was 85 ± 11% for women and 89 ± 13% for men

10

t-test

 

Casey 2009 [87]

Patients were CAD outpatients and as well as diagnosed with stable angina, MI, PCI, CABG, cardiomyopathy, or CHF

n = 637

(459 men, 178 women)

Not described

13 Weeks

CR completion: 92% 422/459 men completed study, 88% 157/178 women completed study

11

t-test between deltas

 

Caulin-Glaser 2005 [97]

Patients with CAD who participated in a CR program

n = 172 (134 men, 38 women)

Not described

12 Weeks

CR completion: 100% (must have completed > 7 weeks)

11

t-test between deltas

 

Caulin-Glaser 2007 [42]

Patients with CABG, PTCA, MI/CAD, or Valve disease

n = 348 (248 men, 100 women)

Not described

12 Weeks

CR completion: 90% 224/248 men, 71% 71/100 women

12

t-test between deltas

 

Chai 1999 [43]

Patients with recent MI, CABG or angioplasty or stable angina pectoris

n = 113 (89 men, 24 women)

Aerobic and Strength

12 Weeks

CR completion: 100%

9

t-test

 

Dehgani 2021 [79]

Patients with MI and HF

n = 40 (20 men, 20 women)

Home-based (Aerobic)

8 Weeks

CR completion: 100%

11

t-test

 

Deljanin-Ilic 2019 [105]

Patients with MI, CABG, PCI

n = 684 (506 men, 178 women)

Aerobic

3 weeks

CR completion: 100%

11

t-test

 

El Missiri 2020 [72]

Patients with CAD and underwent PCI 3 months prior to their enrollment in the study

n = 60 (30 men, 30 women)

Aerobic

12 Weeks

CR completion: 100%

Adherence rate for men was 79.6% and 65.4% for women

12

t-test

 

Fiorina 2007 [69]

Patients had either CABG, valve replacement, or AMI

n = 1622 (1123 men, 499 women)

Aerobic

15 ± 3 Days

CR completion: 100%

12

t-test

 

Freene 2018 [70]

Patients with stable CAD with/ without a revascularization procedure

n = 72 (57 men, 15 women)

Not described

6 Weeks

CR completion: 90%

11

t-test between deltas

 

Gee 2014 [44]

Patients with stable angina, MI, PCI, or CABG

n = 1104 (758 men, 346 women)

Not described

12 Weeks

CR completion: 73% 554/758 men, 66% 227/346 women. Adherence rate for men was 73.1% and was 65.6% for women

12

t-test

 

Ghashghaei 2012 [45]

Patients with CAD including having history of one or more of the following: MI, CABG, PCI, and chronic stable angina

n = 156 (men = 72, women n = 84)

Aerobic and Strength

8 Weeks

CR completion: 100%

11

t-test between deltas

 

Goldhammer 2007 [71]

Patients with CAD, having a history of MI, PCI, and/or CABG 21 to 45 days prior to inclusion to study

n = 37 (23 men, 14 women)

Aerobic

12 Weeks

CR completion: 100%

12

ANOVA

 

Gupta 2007 [68]

Patients with CAD and had either diabetes, dyslipidemia, hypertension or were obese

n = 533 (373 men, 160 women)

Aerobic

8–12 Weeks

CR completion: 100%

11

t-test

 

Heald 2021 [26]

Patients with CAD, spontaneous coronary artery dissection, AF, adult congenital heart disease, cardiomyopathy, PCI, CABG, valve intervention, implantable rhythm device, aneurysm repair, ablation, and those at risk for developing CAD or cardiovascular disease

n = 997 (454 men, 543 women)

Aerobic and strength

26 weeks

CR completion: 62% men, 59% women

11

t-test and ANOVA

 

Jafri 2023 [92]

Patients with NSTEMI, STEMI, PCI, CABG, angina, heart transplant, valve repair/replacement, or HF

n = 15,613 (8825 men, 6788 women)

Aerobic and strength

9 Weeks

CR completion: 65.9% men, 63.3% women

11

t-test

 

Keating 2013 [106]

Patients with CAD and had not had a MI or been hospitalized within the past 3 months. Patients also had a BMI > 27 kg/m 2, and waist circumference > 102 cm (men) or > 88 cm (women)

n = 46 (35 men, 11 women)

Aerobic; Home based

16 Week exercise + 4 Week weight control and exercise

CR completion: 100%

9

ANOVA

 

Keteyian 2003 [17]

Patients with HF caused by left ventricular systolic dysfunction (New York Heart Association class II or III, a resting ejection fraction of < 35%)

n = 15 (10 men, 5 women)

Aerobic

14–24 weeks

CR completion: 100%

11

t-test between deltas

 

Kim 2019 [37]

Patients who underwent PCI after MI or unstable angina visited the CR center at 4 weeks after being discharged from the hospital

n = 586 (451 men, 135 women)

Aerobic

36 Weeks

CR completion: 25% 114/451 men, 21% 30/135 women. Adherence rates between men and women were similar

11

t-test

 

Kitagaki 2022 [41]

Patients with MI

n = 156 (128 men, 28 women)

Aerobic and Strength

12 Weeks

CR completion: 100%

Men attended 10/36 classes and women attended 14/36 classes.

11

t-test and ANOVA

 

Kligfield 2003 [46]

Patients who were referred for a 12-week program of CR because of stable angina or after they experienced MI, CABG, or PCI

n = 81 (58 men, 23 women)

Aerobic

12 Weeks

CR completion: 100%

11

Not described

 

Kodis 2001 [18]

Patients with CABG

n = 1042-

713 in-person CR (612 men; 101 women) 329 home-based CR (296 men; 33 women)

Aerobic and Strength or Home-Based

24 Weeks

In person CR completion: 84% 516/612 men, 82% 83/101 women; Home-based CR completion: 97% 288/296 men, 91% 30/33 women

12

ANOVA

 

Korzeniowska-Kubacka 2015 [57]

Patients with stable angina pectoris (CCS class I or II), sinus rhythm, preserved left ventricular function (ejection fraction > 50%), no evidence of right ventricular dysfunction on echocardiography, and those who were qualified for phase II of a comprehensive, post-MI, CR program

n = 87 (57 men, 30 women)

1/2 Aerobic, 1/2 Home Based

8 Weeks

CR completion: 100%

12

t-test

 

Korzeniowska-Kubacka 2017 [81]

Patients who experienced MI within last 3 months, sinus rhythm, preserved left ventricular function (ejection fraction > 50%), and referred to CR

n = 62 (32 men, 30 women)

Aerobic

8 Weeks

CR completion: 100%

12

t-test and ANOVA

 

Lavie 1995 [47]

Patients with CAD

n = 458 (375 men, 83 women)

Aerobic

12 Weeks

CR completion: 100%

12

t-test and ANOVA

 

Lee 2018 [19]

Patients with CAD

n = 1544 (1359 men, 185 women)

Aerobic + Strength Vs Aerobic Interval Training

24 Weeks

CR completion: 73%

11

t-test

 

MacMillan [30] 2006

Patients who suffered from MI, CABG, PCI, stable angina, revascularization, HF or valve replacement

n = 100 (69 men, 31 women)

Aerobic

12 Weeks

CR completion: 100%

11

t-test

 

Maugeri 1998 [107]

Patients with HF (NYHA class III)

n = 134 (126 men, 8 women)

Aerobic

6–16 Weeks

CR completion: 94%

10

t-test and ANOVA

 

McConnell 1997 [58]

Patients had to have a diagnosis of MI or coronary artery revascularization bypass surgery

n = 581 (456 men, 125 women)

Aerobic

12 Weeks

76% adherence for body composition, 36% for lipid measures, 20% for VO2

12

ANOVA

 

Mertens 1996 [40]

Patients with chronic AF, and/or had a history of valvular disease, or CAD

n = 20 (13 men, 7 women)

Aerobic

52 Weeks

CR completion: 100%

9

Not described

 

Mittag 2006 [90]

Patients suffered with MI, CABG, and PCI

n = 343 (281 men, 62 women)

Home-based

52 Weeks

CR completion: 87%

12

t-test

 

Mroszczyk-McDonald 2007 [20]

Patients who suffered from CABG, MI, PCI, HF, and/or diagnosed with stable angina

n = 1960 (men = 1479, women = 481)

Aerobic and Strength

12 Weeks

CR completion: 34% 505/1479 men, 33% 161/481 women

10

t-test and ANOVA

 

Nguyen 2021 [21]

Patients diagnosed with CAD

n = 63 (40 men, 23 women)

Aerobic and Strength

24 Weeks

CR completion: 100%

12

ANOVA

 

Ocallaghan 1984 [85]

Patients who had MI or PCI

n = 264 (227 men, 37 women)

Aerobic

8 Weeks

CR completion: 92% of men, 81% of women. Men had an attendance rate of 87 ± 14% and women 77 ± 16%.

11

t-test

 

O’Farrell 2000 [75]

Patients with either angina, MI, PTCA, CABG, CHF, cardiomyopathy, valvular disease, or heart transplantation

n = 387 (317 men, 70 women)

Aerobic

12 Weeks

CR completion: 100%. Men attended 83%, while women attended 76%.

12

t-test

 

Pabisiak 2013 [108]

Patients who suffered a MI

n = 61 (34 men, 27 women)

Aerobic and Strength

8 Weeks

CR completion: 100%

11

t-test

 

Pina 2014 [35]

Patients with HF, patients with left ventricular dysfunction (ejection fraction < 35%) and NYHA class 2 to 4

n = 2331 (1670 men, 661 women)

Aerobic

12 Weeks

CR completion: 81% of men and 79% of women. Adherence was 45% for men and 37% for women

12

t-test

 

Pischke 2006 [59]

Patients had a diagnosis of CAD, and a history of CABG, PTCA, angina or MI

n = 343 (286 men, 57 women)

Aerobic

12 Weeks

CR completion: 95% of men completed the study and 95% of women.

12

ANOVA

 

Proenca 2023 [93]

Patients had ACS

n = 881 (739 men, 142 women)

Not described

8–16 Weeks

CR completion: 100%

9

Unknown

 

Quindry 2022 [94]

Patients had MI, CABG, PCI, Angina, HF, valve replacement, or have a heart transplant

n = 31,885 (22,602 men, 9283 women)

Not described

12–36 sessions (length unclear)

CR completion: 100%

12

ANOVA and Mann Whitney U test

 

Rejeski 2002 [60]

Patients with a history of MI, PTCA, chronic stable angina, New York Heart Association Class I or Class II CHF, cardiovascular surgery (coronary artery or valvular heart disease) in the past 6 months

n = 147 (76 men, 71 women)

Aerobic and Strength

12 Weeks

CR completion: 88%

12

ANOVA

 

Rengo 2020 [22]

Patients with a history of CABG, MI, PCI, CHF, stable angina, arrhythmia, and valve surgery

n = 3925(2985 men, 940 women)

Aerobic (some CR had HIIT)

12–16 Weeks

CR completion: 46% of men, 43% of women

12

t-test and ANOVA

 

Sadeghi 2012 [48]

Patients with a history of MI, CABG, PCI, and chronic stable angina

n = 585 (men = 464, women = 121)

Aerobic and Strength

8 Weeks

CR completion: 100%

9

t-test between deltas

 

Saeidi 2013 [49]

Patients with a history of MI, PTCA, CABG, and CAD

n = 100 (69 men, 31 women)

Aerobic

8 Weeks

CR completion: 100%

9

t-test

 

Safdar 2022 [6]

Patients with CABG

n = 420 (344 men, 76 women)

Aerobic and Strength

12 weeks

CR completion: 32% of men, 23% of women.

11

t-test

 

Sarrafzadegan 2008 [50]

Patients had a history of MI, CABG, PCI or CAD

n = 547 (400 men, 147 women)

Aerobic

8 Weeks

CR completion: 45%

12

t-test and ANOVA

 

Savage 2004 [23]

Patients had a history of MI, CABG, CHF, unstable angina or CAD

n = 340 (263 men, 77 women)

Aerobic + Strength

12 Weeks

CR completion: 100%

12

t-test and ANOVA

Sheikhian 2018 [98]

Patients with CAD, at least one coronary artery stenosis, an ejection fraction > 40% without evidence of ischemia or CHF symptoms

n = 30 (15 men, 15 women)

Aerobic

8 Weeks

CR completion: 100%

12

t-test and ANOVA

 

Shultz 2010 [25]

Patients who had a history of CABG, MI, PTCA and/or valve surgery

n = 109 (60 men, 49 women)

Aerobic

12 Weeks

CR completion: 100%

11

t-test

 

Socha 2017 [95]

Patients with CAD following CABG

n = 65 (44 men, 21 women)

Aerobic

3 Weeks

CR completion: 100%

11

Other (Wilcoxon)

 

Soleimani2009a [84]

Patients with CAD who had previously undergone elective PTCA

n = 440 (339 men, 101 women)

Aerobic

8 Weeks

CR completion: 59% of men, 85% of women. 19.3% of patients attended 24 or more sessions

10

t-test

 

Soleimani 2009b [76]

Patients with CAD

n = 216 (168 men, 48 women) -nondiabetics

Aerobic

8 Weeks

CR completion: 100% of men, 81% of women

11

t-test

 

Stojanovic 2023 [82]

Patients with MI, PCI, or myocardial revascularization

n = 1603 (1231 men, 372 women)

Aerobic

3 Weeks

CR completion: 100%

11

t-test

 

Swank 2010 [77]

Patients with CHF, ejection fraction < 35%, with systolic dysfunction

n = 42 (27 men, 15 women)

Aerobic and Strength

14 Weeks

CR completion: 100%

12

ANOVA

 

Szmigielska 2022 [52]

Patients with CAD who had CABG, PCI, or ACS

n = 286 (180 men, 106 women)

Aerobic

8 Weeks

CR completion: 100%

11

t-test and t-test between deltas

 

Temfemo 2011 [31]

Patients who had a history of CABG, artery angioplasty, MI, or valve replacement

n = 188 (112 men, 76 women)

Aerobic

8 Weeks

CR completion: 100%

12

ANOVA

 

Terada 2019a [89]

Patients with a history of CAD, arrhythmia, valvular disease, AF, and/or CHF

n = 120 (60 men, 60 women)

Aerobic (Either AIT or MICE)

8 Weeks

CR completion: 100%

12

t-test and ANCOVA

 

Terada 2019b [78]

Patients diagnosed with angina, CABG, PCI, CAD, CHF, cardiomyopathy, heart murmur, carotid disease, or transient ischemic attack

n = 591 (436 men, 155 women)

Aerobic (On site, home based, or brief)

4–12 weeks

CR completion: 100%

Adherence: 85%

men and 83% women (on-site)

12

t-test and ANCOVA

 

Thorin-Trescases 2016 [24]

Patients diagnosed with ACS

n = 40 (30 men, 10 women)

Aerobic

12 Weeks

CR completion: 100%. Adherence rate for men was 98.9 ± 3.0% and for women 97.0 ± 3.4%

12

ANCOVA and Other (Wilcoxon)

 

Trachsel 2020 [32]

Patients with CAD

n = 83 (64 men, 19 women)

Aerobic and Strength

12-14Weeks

CR completion: 88% of men, 86% of women completed

12

ANOVA

 

Turk-Adawi 2016 [91]

Patients with ACS, revascularization, stable HF, and heart valve repair or replacement

n = 12,976 (8,836 men, 4,140 women)

Not described

12 Weeks

CR completion: 71% of men, 65% of women

12

ANOVA

 

Tyni-Lenne 1998 [39]

Patients with CHF, ejection fraction < 40%, New York Heart Association (NYHA) functional class II and class III

n = 24 (12 men, 12 women)

Knee extensor exercise

8 Weeks

CR completion: 100%

Adherence to program ranged from 86–100% with no sex-related differences.

12

t-test and ANOVA

 

Verrill 2003 [67]

Patients with CAD, and/or angina, valvular disease or replacement, CHF or MI

n = 630 (424 men and 206 women)

Aerobic and Strength

10–12 Weeks

CR completion: 100%

12

ANOVA

 

Vidal-Almela 2022 [36]

Patients with CAD, arrhythmias, valvular disease, angina, stroke, HF, spontaneous coronary artery dissection, PCI, CABG, valve replacement, PCI + CABG, catheter ablation

n = 140 (100 men, 40 women)

Aerobic (HIIT)

10 weeks

CR completion: 100% Adherence 78% men, 77% women

11

ANCOVA

 

Vilela 2020 [33]

Patients who suffered from AMI

n = 379 (307 men, 72 women)

Aerobic and Strength

8 Weeks

CR completion: 100%. Adherence: Patients completed a median of 22 sessions (16–25 sessions)

12

t-test

 

Wagner 2018 [34]

Patients with AF

n = 210 (151 men, 59 women)

Aerobic and Strength

12 Weeks

CR completion: 82% of men, 88% of women. Adherence to the training sessions was higher in men (47%) than in women (40%)

11

t-test

 

Wahlstrom 2023 [80]

Patients with AF

n = 64 (28 men, 36 women)

Yoga

12 Weeks

CR completion: 100%

11

t-test

 

Warner 1995 [88]

Patients were referred after MI, CABG, percutaneous balloon angioplasty, cardiomyopathy, and/or stable angina

n = 719 (553 men 166 women)

Aerobic

260 Weeks

CR completion: 12% 69/553 men, 8% 14/166 women. Adherence was 70% for men and 68% for women

12

t-test and ANCOVA

 

Weinberger 2014 [86]

Patients with PTCA, CABG, MI, valve replacement, CAD, CHF, angina or cardiomyopathy

n = 1138 (843 men, 295 women)

Not described

≥ 7weeks; average 11 weeks

CR completion: 49% Adherence was 11.5 weeks for men and 11.4 weeks for women

12

Other (Logistic regression)

 

Willenheimer 1998 [38]

Patients with HF and ejection fraction < 45%

n = 33 (27 men, 6 women)

Aerobic

16 Weeks

CR completion: 91% Adherence for men was 78% and for 67% women

12

t-test

 

Wise 2012 [51]

Patients with CHF (NYHA level I-III) also diagnosed with CAD, cardiomyopathy, valvular disease, and or/tachycardia

n = 232 (172 men, 60 women)

Aerobic and Strength

12 Weeks + median of 4 extra weeks

CR completion: 100% All patients attended at least 40% of sessions.

11

Other (Wilcoxon)

 

Zahedi 2022 [74]

Patients with MI and PCI

n = 30 (23 men, 7 women)

Aerobic

5 Weeks

CR completion: 100%

9

Other (Wilcoxon)

 

Zahedi 2023 [73]

Patients with CABG

n = 100 (67 men, 33 women)

Aerobic

4 weeks

CR completion: 100%

11

Other (Wilcoxon)

 
  1. ACS; acute coronary syndrome, AF; atrial fibrillation, AMI; acute myocardial infarction, BMI; body mass index, CABG; coronary artery bypass grafting, CAD; coronary artery disease, CHF; chronic heart failure, CR; cardiac rehabilitation, HF; heart failure, HIIT; high intensity interval training, MI; myocardial infarction, NYHA; New York heart association PCI; percutaneous coronary intervention, PTCA; percutaneous transluminal coronary angioplasty