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J Am Coll Cardiol, 2001; 37:1891-1900 © 2001 by the American College of Cardiology Foundation |
* G. M. Lancisi Department of Cardiology and Cardiac Surgery, Division of Cardiology 1, Ancona, Italy
Department of Cardiac Rehabilitation, Division of Cardiology 1, Ancona, Italy
Department of Chemistry, Division of Cardiology 1, Ancona, Italy
Department of Nuclear Medicine, Division of Cardiology 1, Ancona, Italy
|| Department of Cardiovascular Radiology and Hemodynamics, Division of Cardiology 1, Ancona, Italy
¶ Columbia University, Department of Medicine, New York, New York, USA
Manuscript received August 14, 2000; revised manuscript received January 26, 2001, accepted February 12, 2001.
Reprint requests and correspondence: Dr. Romualdo Belardinelli, Via Rismondo, 5-60100 Ancona, Italy.
r.belardinelli{at}fastnet.it
OBJECTIVES
The goal of this study was to determine the effects of exercise training (ET) on functional capacity and quality of life (QOL) in patients who received percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting (CS), the effects on the restenosis rate and the outcome.
BACKGROUND
It is unknown whether ET induces beneficial effects after coronary angioplasty.
METHODS
We studied 118 consecutive patients with coronary artery disease (mean age 57 ± 10 years) who underwent PTCA or CS on one (69%) or two (31%) native epicardial coronary arteries. Patients were randomized into two matched groups. Group T (n = 59) was exercised three times a week for six months at 60% of peak 
O2. Group C (n = 59) was the control group.
RESULTS
Only trained patients had significant improvements in peak O2 (26%, p < 0.001) and quality of life (26.8%, p = 0.001 vs. C). The angiographic restenosis rate was unaffected by ET (T: 29%; C: 33%, P = NS) and was not significantly different after PTCA or CS. However, residual diameter stenosis was lower in trained patients (–29.7%, p = 0.045). In patients with angiographic restenosis, thallium uptake improved only in group T (19%; p < 0.001). During the follow-up (33 ± 7 months) trained patients had a significantly lower event rate than controls (11.9 vs. 32.2%, RR: 0.71, 95% confidence interval [CI]: 0.60 to 0.91, p = 0.008) and a lower rate of hospital readmission (18.6 vs. 46%, RR: 0.69, 95% CI: 0.55 to 0.93, p < 0.001).
CONCLUSIONS
Moderate ET improves functional capacity and QOL after PTCA or CS. During the follow-up, trained patients had fewer events and a lower hospital readmission rate than controls, despite an unchanged restenosis rate.
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