Abstract 13799: C-Reactive Protein Decreases through Cardiac Rehabilitation Only in Overweight/Obese Patients After Acute Myocardial Infarction, Independent of Body Weight Change, Diabetes, Statin, or Smoking
Backgrounds: Cardiac rehabilitation with exercise training (CR/ET) has been reported to be associated with reduction in C-reactive protein (CRP) in patients with coronary artery disease. However, this finding was obtained mostly in the population of overweight or obese (OW/OB) patients, and hence, it remains unknown whether reduction in CRP through CR/ET occurs in a broad range of body mass index.
Methods: To address this issue, we studied 443 acute myocardial infarction (AMI) patients who participated in 3-month CR/ET program and underwent measurements for peak oxygen uptake (PVO2) by symptom-limited cardiopulmonary exercise test and CRP at the beginning and the end of the program. Patients who had abnormally high CRP (>= 2.0mg/dL at baseline, >=1.0mg/dL at 3 months) were excluded. Patients were categorized into 3 groups according to the mean value+/-1SD of Body Mass Index (BMI): OW/OB group (BMI>=26, n=73), Normal group (20<=BMI<26, n=298), and Lean group (BMI<20, n=62).
Results: As expected, OW/OB group were young (59 vs 64 vs 66years, p<0.01), and had lower BNP levels and higher prevalences of hypertension, dyslipidemia and smoking, but had similar left ventricular ejection fraction (45 vs 46 vs 45%, NS). After the 3-month CR/ET program, PVO2 increased and CRP decreased in all three groups. Notably, there was a significant inverse correlation (r=-0.40, p<0.05) between changes in CRP (ΔCRP) and changes in PVO2 (%ΔPVO2) in OW/OB group, whereas there were no significant correlations in Normal (r=-0.11, NS) and Lean groups (r=-0.20, NS). In contrast, ΔCRP was not correlated with changes in body weight (ΔBW) in either group, suggesting that the association between ΔCRP and %ΔPVO2 was not mediated by ΔBW. Furthermore, in subgroup analysis in OW/OB group, the association between ΔCRP and %ΔPVO2 remained significant regardless of the presence or absence of diabetes (r=-0.34 and -0.49, both p<0.05), statin therapy (r=-0.42 and -0.62, both p<0.01), and current smoking (r=-0.40 and -0.41, both p<0.05).
Conclusion: CRP is decreased only in OW/OB patients in association with increased PVO2, but not with BW reduction, through CR/ET after AMI. These findings suggest a pathologic link between exercise training and inflammation in OW/OB patients after AMI.
- © 2013 by American Heart Association, Inc.