Abstract 5075: Safety and Efficacy of Exercise Training from the Next Day of Elective Coronary Stenting
Background: Exercise therapy immediately after coronary stenting is considered to have a risk of stent thrombosis, however few reports have examined the strength and start time of exercise therapy after stenting. Aim: To investigate the safety and efficacy of exercise therapy in the early phase after elective coronary stenting.
Method: We enrolled 2351 patients who underwent elective coronary stenting. Groups of patients (exercise group 865 patients and control group 1486 patients) were compared. We performed exercise training below anaerobic threshold (AT) level on the next day after coronary stenting. Then they continued the same degree exercise more than 3 times a week after discharge. Primary endpoint was the incidence of stent thrombosis within 30 days. Stent thrombosis was defined as the following criteria:
angiographically documented stent occlusion or presence of filling defect in the stent after stent replacement or
Myocardial infarction or sudden cardiac death without proven patency of the stent after stent replacement.
Secondary endpoint was the incidence of major adverse event (MAE) and exercise continuation rate at 30 days. MAE was defined as death, acute coronary syndrome, stroke and coronary artery bypass graft surgery.
Result: At 30 days, clinical follow-up information was obtained in 2327 (99%) patients. Exercise group had younger average age and more male gender. And exercise group was with more left anterior descending artery lesion compared to non-exercise group, but other baseline characteristics were similar in both groups. No cardiac events occurred during exercise on the next day after stenting. There was no significant difference in the frequency of MAE (0.35% vs. 0.34%, p=0.51) or stent thrombosis (0.23% vs. 0.27%, p=0.65) within 30 days, and there were no exercise-related events. The exercise continuation rate was significantly higher (74% vs. 26%, p<0.0001) and unscheduled hospital visiting was lower (8% vs. 13%, p=0.0005) in the exercise therapy group at 30 days.
Conclusion: Based on these findings, the safety of exercise training below AT level after elective coronary stenting within thirty days was favorable. And the starting of exercise therapy from the ext day was effective for exercise continuation within 30 days.