title: Regular exercise training compared with percutaneous intervention leads to a reduction of inflammatory markers and cardiovascular events in patients with coronary artery disease.
abstract: BACKGROUND
  Chronic vascular inflammation may trigger ischemic events whereas regular physical exercise training (ET) has shown to be cardioprotective in patients with coronary artery disease (CAD). We investigated the impact of 2 years regular ET versus percutaneous intervention (PCI) on chronic inflammation and cardiovascular events.
  
  
  RESULTS
  A total of 101 male patients with stable CAD and an indication for revascularization were prospectively randomized to regular ET (n=51) or PCI with stentimplantation (n=50). High-sensitive C-reactive protein and interleukin-6, exercise capacity and ischemic endpoints were analyzed at baseline and after 2 years. At 2 years maximal oxygen consumption (VO2 max) increased by 10% in the ET group (23.3+/-0.6 to 25.7+/-1.0 ml O2/kg/min; P=0.0171 versus baseline) versus 7% in the PCI group (22.3+/-0.8 to 23.9+/-1.2 ml O2/kg/min; P=0.4248). In a subgroup of patients, high-sensitive C-reactive protein levels and interleukin-6 levels were significantly reduced after ET by 41 and 18%, respectively, whereas no relevant changes were observed in the PCI group. Event-free survival rates after 24 months were 78% (ET) versus 62% (PCI) (P=0.039).
  
  
  CONCLUSIONS
  In patients with stable coronary artery disease, regular physical exercise is associated with a reduction of inflammatory markers and ischemic events.
authors.affiliation: Department of Cardiology, Heart Center, University of Leipzig, Leipzig, Germany. waltherc@medizin.uni-leipzig.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Walther
authors.forename: Sven
authors.initials: S
authors.lastname: Möbius-Winkler
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.forename: Mathias
authors.initials: M
authors.lastname: Bruegel
authors.forename: Joachim
authors.initials: J
authors.lastname: Thiery
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Rainer
authors.initials: R
authors.lastname: Halbrecht
mesh_terms: D000704:Analysis of Variance; D000800:Angioplasty, Balloon; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003327:Coronary Disease / Q000097:blood / Q000534:rehabilitation* / Q000628:therapy*; D015536:Down-Regulation; D005081:Exercise Therapy; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015850:Interleukin-6; D008055:Lipids; D002097:C-Reactive Protein