Long-term effect of rehabilitation in coronary artery disease patients: randomized clinical trial of the impact of exercise volume.
OBJECTIVE
To assess whether exercise volume during phase II rehabilitation affects long-term clinical benefits in patients with coronary artery disease.


METHODS
Prospective randomized clinical trial with long-term follow-up.


METHODS
Hospital outpatient clinic.


METHODS
Coronary artery disease patients (age 65 +/- 9 years, 82% males) attending a phase II rehabilitation programme were randomized into two groups of exercise volumes: 40- versus 60-minute training sessions. Patients exercised for three days per week for seven weeks, at 65% of baseline oxygen uptake capacity. Next, they were followed up for 18 months. Out of 165 patients with coronary artery disease who completed the exercise intervention, 119 attended the 18-month follow-up assessment.


METHODS
Body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, smoking behaviour, habitual physical activity, cardiovascular disease incidence and mortality.


RESULTS
In total population, a significant worsening of various cardiovascular disease risk factors was found at 18 months follow-up (P<0.05), and few patients (27% of total group) adhered to the recommended minimal physical activity level. No difference in change of body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, and smoking behaviour was seen between different exercise volumes (P>0.05). In addition, total cardiovascular disease incidence (13% versus 22% in 40- versus 60-minute group, respectively) and habitual physical activity were not different between groups (P>0.05).


CONCLUSIONS
In patients with coronary artery disease following cardiac rehabilitation, the cardiovascular disease risk profile worsened significantly during long-term follow-up. A smaller exercise volume during phase II rehabilitation generated equal long-term clinical benefits compared to a greater exercise volume.
Hansen
Dominique
D
Jessa Hospital, Rehabilitation and Health Centre, Heart Centre Hasselt, Hasselt and Vrije Universiteit Brussel, Department of Human Physiology and Sportsmedicine, Brussels, Belgium. rmeeusen@vub.ac.be
Dendale
Paul
P
Raskin
Anita
A
Schoonis
Annick
A
Berger
Jan
J
Vlassak
Irmien
I
Meeusen
Romain
R
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000534:rehabilitation*; D023903:Coronary Restenosis / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D010349:Patient Compliance; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D019233:Retreatment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D055105:Waist Circumference
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D008055:Lipids; D010975:Platelet Aggregation Inhibitors; D002097:C-Reactive Protein