Abstract 16598: Regular Exercise Training Reduce Coronary Restenosis After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
Background. Cardiac rehabilitation (CR) is known to have beneficial effects in patients with coronary artery disease. However, it is not known whether CR including regular exercise training (ET) is cardioprotective in patients with acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of regular ET on coronary restenosis and its association with inflammatory markers following percutaneous coronary intervention (PCI) for AMI.
Methods Consecutively 68 AMI patients who underwent PCI with implantation of a drug-eluting stent and 9 month follow-up angiography were included. Patients received either CR including ET (n=33, a 6-8 weeks supervised regular ET and subsequent self-managed exercise) or conventional therapy without ET (age-matched control group, n=35). At 9 months, angiographic restenosis measured as in-segment late luminal loss of the stented coronary area via quantitative coronary angiography using CAAS 5.9.
Results There were no significant differences in baseline characteristics including age, sex, BMI, smoking, DM, hypertension, level of lipid profile, use of statin, CBC, and high-sensitivity C-reactive protein (hs-CRP) between 2 groups. At 9 months follow-up angiography, late luminal loss was smaller in the ET group 0.08 ± 0.28 mm compared to the control (CON) group 0.43 ± 0.75 mm (P=0.02). At 6 weeks, maximal oxygen consumption increased in ET group by 10.2±2.3% (p<0.01). Neutrophil count at 9 month was lower in ET group (2,730 ± 1,413 vs 4,123 ± 1,287, p<0.001). Serum HDL-cholesterol level in ET group was higher than CON group (46 ± 22.7 vs 42 ± 10.6, p=0.07) at 9 month. Levels of hs-CRP decreased by 0.9 ± 2.0 mg/L in the ET group and by 0.53 ± 1.64 mg/L in the CON group (p=0.39 for trend).
Conclusion Regular ET contributed a reduction in late luminal loss in the stented coronary segment in AMI patients. This effect may be associated with increased aerobic exercise capacity, improved HDL-cholesterol, and attenuated inflammation.
- © 2011 by American Heart Association, Inc.