title: Independent effect of cardiac rehabilitation on lipids in coronary artery disease.
abstract: OBJECTIVE
  We evaluate the effects cardiac rehabilitation (CR) participation independent of using lipid-altering agents (LAAs) on low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol, and triglyceride. Measurements included absolute and relative change in lipids and increases in percent of patients achieving goals.
  
  
  METHODS
  Analysis of 766 patients who participated in CR between 2000 and 2003 was performed. On enrollment to CR, all were being treated with an LAA defined as HIviG-CoA reductase inhibitors, bile acid sequestrant, fibrate, and niacin, hormone replacement therapy. Preenrollment and postenrollment lipids were obtained. Analysis was performed on 2 cohorts, participants enrolled on an LAA with no change in medication (n = 13) and participants enrolled on an LAA with a change in medications (n = 153).
  
  
  RESULTS
  At completion of CR, 74.9% of patients on LAA at enrollment with no medication adjustments during the program were at Adult Treatment Panel III goal for low-density lipoprotein cholesterol compared with 68.5% at entry (P = .01), all other lipid parameters also significantly improved. Sixty-three percent who started CR on an LAA and had dose adjustment or an additional LAA added achieved low-density lipoprotein cholesterol goal compared with 43.1% at entry (P < .0001).
  
  
  CONCLUSIONS
  Participation in CR significantly potentiates the lipid-improving effects of pharmacological therapy and independently contributed to the percent of patients achieving all lipid levels at Adult Treatment Panel III goal.
authors.affiliation: McConnell Heart Health Center and Riverside Methodist Hospital, OhioHealth, Columbus, OH 43214-3646, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Snow
authors.forename: Michelle
authors.initials: M
authors.lastname: LaLonde
authors.forename: Lisa
authors.initials: L
authors.lastname: Hindman
authors.forename: James
authors.initials: J
authors.lastname: Falko
authors.forename: Teresa
authors.initials: T
authors.lastname: Caulin-Glaser
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000032:analysis / Q000187:drug effects; D008078:Cholesterol, LDL / Q000032:analysis / Q000187:drug effects; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control / Q000534:rehabilitation*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL