Regular exercise training reduces coronary restenosis after percutaneous coronary intervention in patients with acute myocardial infarction.
BACKGROUND
It is well known that cardiac rehabilitation (CR) including regular exercise training (ET) is cardioprotective with respect to clinical events in patients with acute myocardial infarction (AMI). However, it is not known whether the regular ET may affect coronary restenosis after percutaneous coronary intervention (PCI) with stenting in AMI. The aim of this study was to evaluate the effect of regular ET on a stented coronary segment and its association with inflammatory markers in AMI.


METHODS
Consecutively 74 AMI patients who underwent PCI with implantation of a drug-eluting stent and 9 month follow-up angiography were included. Thirty seven patients who received CR with ET were assigned to the ET group. Another 37 patients who did not participate in ET, of similar age to those of participants, were assigned to the control group. At 9 months, angiographic restenosis measured as in-segment late luminal loss of the stented coronary artery was analyzed via quantitative coronary angiography using CAAS 5.9.


RESULTS
There were no significant differences in baseline characteristics including age, sex, body mass index, smoking, DM, hypertension, lipid profile, use of statin, and complete blood cell between two groups. On 9 month follow-up angiography, late luminal loss per stent was significantly smaller in the ET group compared to the control group (0.14 ± 0.57 vs. 0.54 ± 0.88 mm, p=0.02). Maximal oxygen consumption (VO2max) significantly improved in the ET group after 9months (27.9 ± 6.4 vs. 30.8 ± 5.2 mL/kg/min, p<0.001). Increment in high density lipoprotein-cholesterol (HDL-C) was significantly larger in the ET group at 9 months (0.15 ± 0.12 vs. 0.04 ± 0.24 mg/dL, p=0.03).


CONCLUSIONS
Regular ET contributes to a significant reduction in late luminal loss in the stented coronary segment in AMI patients. This effect was associated with increased exercise capacity and increased HDL-C.
Department of Cardiology, Severance Hospital, Yonsei University, Seoul, Republic of Korea.
Hye Young
HY
Lee
Jeong Hoon
JH
Kim
Byung Ok
BO
Kim
Young-Sup
YS
Byun
Sungwoo
S
Cho
Choong Won
CW
Goh
Hyoseung
H
Ahn
Kun Joo
KJ
Rhee
Chul
C
Kim
D000368:Aged; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011859:Radiography; D016896:Treatment Outcome