title: Effect of exercise-based cardiac rehabilitation on non-culprit mild coronary plaques in the culprit coronary artery of patients with acute coronary syndrome.
abstract: Approximately, 70 % of acute myocardial infarctions are known to develop from mild atherosclerotic lesions. Therefore, it is important to evaluate mild coronary plaques to prevent acute coronary syndrome (ACS). The aim of the present study was to investigate the effects of exercise-based cardiac rehabilitation (CR) on mild coronary atherosclerosis in non-culprit lesions in patients with ACS. Forty-one men with ACS who underwent emergency percutaneous coronary interventions and completed a 6-month follow-up were divided into CR and non-CR groups. Quantitative coronary angiography (QCA) was performed using the automatic edge detection program. The target lesion was a mild stenotic segment (10-50 % stenosis) at the distal site of the culprit lesion, and the segment to be analyzed was determined at a segment length ranging from 10 to 15 mm. The plaque area was significantly decreased in the CR group after 6 months, but was significantly increased in the non-CR group (P < 0.05). The low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein (HDL) ratio and high-sensitivity C-reactive protein (Hs-CRP) levels were significantly reduced in both groups (P < 0.01). Peak VO2 in the CR group was significantly increased (P < 0.01). Changes in the plaque area correlated with those in Hs-CRP in both groups, while that association with those in HDL-C was observed in only CR group. Stepwise regression analysis revealed the decrease in Hs-CRP as an independent predictor of plaque area regression in the CR group. CR prevented the progression of mild coronary atherosclerosis in patients with ACS.
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan. sato_itsu@yahoo.co.jp.|Disease Prevention Center, Ijinkai Takeda General Hospital, Kyoto, Japan. sato_itsu@yahoo.co.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurose
authors.affiliation: Department of Medicine II, Kansai Medical University, Hirakata, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Iwasaka
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tsutsumi
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamanaka
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shinno
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Yaeko
authors.initials: Y
authors.lastname: Fukushima
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Higurashi
authors.affiliation: EBM Center for Preventive Medicine, Takeda Hospital Group, Kyoto, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Imai
authors.affiliation: EBM Center for Preventive Medicine, Takeda Hospital Group, Kyoto, Japan.
authors.forename: Izuru
authors.initials: I
authors.lastname: Masuda
authors.affiliation: Department of Cardiovascular Medicine, Ijinkai Takeda General Hospital, Kyoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takeda
authors.affiliation: Department of Cardiovascular Medicine, Ijinkai Takeda General Hospital, Kyoto, Japan.
authors.forename: Chuichi
authors.initials: C
authors.lastname: Kawai
authors.affiliation: Department of Health Science, Graduate School of Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D000072038:Cardiac Rehabilitation / Q000009:adverse effects / Q000379:methods*; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation*; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D018450:Disease Progression; D005080:Exercise Test; D005081:Exercise Therapy / Q000009:adverse effects; D017079:Exercise Tolerance; D006801:Humans; D007564:Japan; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D008075:Lipoproteins, HDL; D002097:C-Reactive Protein
keywords: Cardiac rehabilitation; Exercise tolerance; High-sensitivity C-reactive protein; Mild coronary stenosis; Plaque area