Physical training after percutaneous coronary intervention in patients with stable angina: effects on working capacity, metabolism, and markers of inflammation.
OBJECTIVE
Physical activity is effective in primary and secondary prevention of cardiovascular disease. In this study, we tested the hypothesis that exercise training improves glucose and lipid metabolism, the inflammatory/anti-inflammatory balance, and the outcome of elective percutaneous coronary intervention (PCI) in patients with stable coronary disease.


METHODS
Sixty-two patients scheduled to undergo PCI for stable angina were randomized to intensive physical activity (n=33) consisting of home-based exercise on a bicycle ergometer or maintain their usual sedentary life (n=29). The training program started 2 months before PCI and terminated 6 months afterwards. Clinical examination, blood sampling (fasting glucose, glycated hemoglobin, lipid profile, apolipoprotein B, apolipoprotein A1, C-reactive protein, serum amyloid A, interleukin-6, interleukin-8, and interleukin-10), and maximal exercise tests were performed at inclusion, 1 week before PCI, and 3 and 6 months afterwards.


RESULTS
Fifty-six patients [28 per group, 45 men, mean age 63 (SD 7.8) years] completed the follow-up. According to self-reports, patients in the training group exercised more often and longer [4.9 (SD 1.1) vs. 0.6 (SD 1.3) days/week, 36 (SD 12) vs. 15 (SD 31) min/session, P<0.0001]. Improvement in maximal exercise capacity was significantly better in the training group [27 (SD 27) vs. 9 (SD 27) W, P=0.02]. Exercise had no significant effects on glucose and lipid metabolism, plasma cytokines, or acute-phase reactants.


CONCLUSIONS
A home-based training program significantly improved maximal exercise capacity but did not affect glucose or lipid metabolism or markers of inflammation.
Astengo
Marco
M
Department of Geriatrics, Ospedale San Giovanni Battista, Torino, Italy.
Dahl
Asa
A
Karlsson
Thomas
T
Mattsson-Hultén
Lillemor
L
Wiklund
Olov
O
Wennerblom
Bertil
B
D000368:Aged; D000787:Angina Pectoris / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D003327:Coronary Disease / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D004734:Energy Metabolism; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006699:Home Care Services; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000685:Serum Amyloid A Protein / Q000378:metabolism; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D016753:Interleukin-10; D015850:Interleukin-6; D016209:Interleukin-8; D008055:Lipids; D000685:Serum Amyloid A Protein; C505693:APOA1 protein, human; C508606:CXCL8 protein, human; C508609:IL10 protein, human; C508600:IL6 protein, human; C517652:hemoglobin A1c protein, human