Phase III/IV cardiac rehabilitation (CR) is recommended to promote maintenance of benefits achieved during Phase II; there has been no meta-analysis to test this to date. This study determined the effects of maintenance CR on any outcome, with consideration of sex. Seven databases were searched from inception-January 2020. Randomized controlled trials on the effects of maintenance CR in cardiovascular disease patients who had graduated from CR were included. Level of evidence was evaluated with GRADEPro. 819 citations were identified, with 10 trials (21 papers) included (5238 participants; 859 [16.4%] female). Maintenance CR resulted in lower low-density lipoprotein (mean difference [MD]=-0.58; 95% confidence interval [CI]=-1.06–-0.10, n = 392) and greater quality of life (MD = 0.28, 95% CI = 0.05–0.52, n = 118) when compared to usual care only. Outcomes for women and sex differences were mixed. In conclusion, maintenance programs appear to sustain patient's quality of life, but more focus on women's outcomes is needed.

建议进行III / IV期心脏康复（CR），以促进维持在II期中获得的收益；迄今为止，还没有荟萃分析来检验这一点。这项研究考虑了性别，确定了维持性CR对任何结局的影响。从开始到2020年1月，共检索了七个数据库。其中包括关于维持CR对从CR毕业的心血管疾病患者的影响的随机对照试验。证据水平使用GRADEPro进行了评估。确定了819条引用文献，其中包括10项试验（21篇论文）（5238名参与者； 859名[16.4％]女性）。维持CR可降低低密度脂蛋白（平均差[MD] =-0.58； 95％置信区间[CI] =-1.06--0.10，n  = 392）和更高的生活质量（MD = 0.28，95 ％CI = 0.05–0.52， 仅与常规护理相比，n = 118）。妇女的结果和性别差异参差不齐。总之，维持计划似乎可以维持患者的生活质量，但是需要更多地关注女性的结局。