Abstract 16029: Lifestyle Modifications Regress Coronary Artery Atherosclerosis

Abstract

Background and Purpose: Coronary artery plaque progression has been associated with significant cardiovascular morbidity and mortality. Even though, lifestyle modifications are the cornerstone of the management of coronary artery disease, the effect of a healthy diet and regular exercise on the progression of coronary artery narrowing is not clear. This meta-analysis was undertaken to assess this possibility.

Methods: Randomized controlled trials comparing the efficacy of intensive lifestyle measures (diet and/or exercise) and usual care were identified by a systematic search. Three independent researchers searched MEDLINE, OVid, PUBMED, EMBASE and CINAHL for eligible studies. We included studies which provided baseline and 1 year quantitative coronary angiographic data. Comprehensive Meta-Analysis Version 2.0 was used for statistical analysis.

Results: We identified 5 eligible studies of which 3 studies looked at the effect of diet and exercise while 1 looked at the effect of diet alone. One study was excluded from the analysis because of lack of sufficient data. There was no significant heterogeneity between the 4 studies analyzed (p: 0.507). A total of 621 lesions from 196 patients were analyzed; 301 lesions in the intervention group and 320 lesions in the control group. After one year of follow up, coronary artery percent stenosis regressed from 54.2±17.93 to 51.7±17.95 (p<0.001, difference of mean -2.5; CI:-5.37 to -0.37) in the lifestyle intervention group while atherosclerosis progression from 52.89±19.9 to 59.44±21.2 (p<0.001, difference of mean 6.55; CI:3.35 to 9.74) was noted in the control group. The pooled effect size for coronary atherosclerosis progression in the lifestyle modification group compared to the control group was -0.307 (95% CI= -0.465 to -0.148, p<0.001 ) (Figure).

Conclusion: Lifestyle changes i.e diet and exercise, not only decrease the progression but also regress coronary artery atherosclerosis after one year of follow up.