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Life sciences · Review
Sport Sciences for Health · August 14, 2026
Well-designed and adequately powered for the question it asks.
This network meta-analysis of 78 RCTs demonstrates that moderate-to-high intensity aerobic exercise (MICT, HICT) improves peak oxygen uptake and reduces mortality risk in adults with CAD compared to usual care or no exercise, with HIIT showing superior VO₂peak gains over MICT. However, the authors emphasize that certainty of evidence is low to very low, several comparisons rely on indirect evidence, and no intensity was shown superior for quality of life; they conclude that firm intensity-specific recommendations require adequately powered head-to-head trials using isocaloric protocols.
Systematic review and network meta-analysis. Adults with coronary artery disease enrolled in randomized trials of aerobic exercise interventions.. Intervention: Aerobic exercise at different intensities: low-intensity continuous training (LICT), moderate-intensity continuous training (MICT), high-intensity continuous training (HICT), and high-intensity interval training (HIIT), classified by Europ…. Compared with: Usual care (cardiac rehabilitation without structured aerobic prescription), another aerobic intensity, or no intervention (control).. n = 6,287. Not stated.
For VO₂peak versus usual care, HIIT showed improvement of 3.92 mL/kg/min (95% CI 2.87 to 4.96), HICT 3.70 (2.58 to 4.82), and MICT 2.94 (2.24 to 3.63); LICT showed no significant improvement. HIIT was superior to MICT in direct comparison for VO₂peak (MD 1.37, 95% CI 0.41 to 2.33). For mortality, HICT (RR 0.51, 95% CI 0.33 to 0.79) and MICT (RR 0.63, 95% CI 0.42 to 0.94) were associated with fewer events than no exercise.
HIIT did not contribute data to the mortality network, limiting intensity-specific mortality conclusions. For mortality, HICT (RR 0.51, 95% CI 0.33 to 0.79) and MICT (RR 0.63, 95% CI 0.42 to 0.94) were associated with fewer events than no exercise.
Clinicians should counsel CAD patients that moderate-to-high intensity aerobic exercise—MICT or HICT—improves fitness and may reduce mortality risk. However, evidence for superiority of any single intensity over another remains uncertain; exercise prescription should be individualized and preferably delivered via structured cardiac rehabilitation until better-quality direct comparisons are available.
Rigorous network meta-analysis of 78 RCTs with prespecified protocol and low-bias assessment, showing moderate-to-high intensity aerobic exercise improves VO₂peak and reduces mortality in CAD, but certainty is limited by heterogeneity and indirect comparisons.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should counsel CAD patients that moderate-to-high intensity aerobic exercise—MICT or HICT—improves fitness and may reduce mortality risk. However, evidence for superiority of any single intensity over another remains uncertain; exercise prescription should be individualized and preferably delivered via structured cardiac rehabilitation until better-quality direct comparisons are available.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Objective To investigate, in adults with coronary artery disease (CAD), (i) the comparative effectiveness of aerobic exercise interventions differing in intensity and/or pattern—low-, moderate- and high-intensity continuous training (LICT, MICT, HICT) and high-intensity interval training (HIIT)—versus usual care or no exercise, and (ii) the relative effectiveness of continuous versus interval modalities, on peak oxygen uptake (VO₂peak), health-related quality of life (HRQoL), and mortality. Data sources MEDLINE (PubMed), CENTRAL, EMBASE, PEDro, and Google Scholar were searched from inception to June 2026, with grey-literature sources and reference-list screening, without language restrictions. Study selection Randomized trials were eligible per our PICO strategy. Population: adults with CAD; Intervention: aerobic exercise classified by intensity following the European Association of Preventive Cardiology; comparator: another aerobic intensity, usual care (cardiac rehabilitation without structured aerobic prescription), or control (no intervention); outcomes: VO₂peak (primary), HRQoL and mortality (secondary). Data extraction Two reviewers independently extracted data and appraised methodological quality (PEDro); risk of bias for the certainty assessment used RoB 2 within CINeMA. Data synthesis 78 trials (6287 participants) were included; 58 (3171 participants) contributed to VO₂peak, 7 (553) to HRQoL and 13 (2,563) to mortality. For VO₂peak versus usual care, HIIT (MD = 3.92 mL/kg/min, 95%CI 2.87 to 4.96), HICT (3.70, 2.58 to 4.82) and MICT (2.94, 2.24 to 3.63) showed significant improvements, whereas LICT did not; HIIT was superior to MICT in direct comparison (1.37, 0.41 to 2.33). Local inconsistency involving the MICT node was resolved in a pre-specified sensitivity analysis, after which the advantage of HICT over MICT was substantially attenuated. For HRQoL, the only significant signal (LICT) derived from a single trial and did not survive leave-one-out analysis; no intensity was shown superior to usual care. For mortality, HICT (RR = 0.51, 0.33 to 0.79) and MICT (RR = 0.63, 0.42 to 0.94) were associated with fewer events than no exercise, while HIIT did not contribute to this network. Certainty of evidence was low to very low across outcomes. Conclusions Aerobic exercise may improve VO₂peak and, at moderate-to-high intensity, may be associated with lower mortality in CAD. Any apparent superiority of higher intensities should be interpreted with caution, given the low to very low certainty, reliance on indirect evidence for several comparisons, and the absence of isocaloric protocols. Adequately powered head-to-head trials using isocaloric protocols are needed before firm intensity-specific recommendations can be made.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.