Impact of Cardiac Rehabilitation Schedule on Cardiovascular Compliance in Patients with Coronary Artery Disease Undergoing Coronary Artery Bypass Surgery or Angioplasty

Abstract

Background: In Iran, coronary artery disease (CAD) is responsible for the highest cardiovascular mortality rate. Many studies show significant improvements in cardiovascular status in patients with CAD and undergoing percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG) after cardiac rehabilitation (CR) programs. In this study, the impacts of CR were evaluated on Iranian patients who had undergone CABG or PTCA.

Methods: This single-center, case-crossover study‎ was conducted on 69 patients with CAD; 39 and 30 patients had undergone PTCA and CABG, respectively. The patients completed a 24-session structured multidisciplinary CR program. Exercise tolerance testing, echocardiographic data, and laboratory parameters were recorded before and after the program.

Results: Mean age of the subjects was 62.8 years, and 14.5% of them were women and 85.5% were men. The most frequent risk factors for CAD in the study population were systolic hypertension (42.0%) followed by current smoking (27.5%) and diabetes mellitus (24.5%). Compared with pre-CR, the metabolic equivalent (MET) attained was significantly increased after completion of the CR program (P = 0.002). Significant improvements in left ventricular ejection fraction (LVEF) (P = 0.012) and high density lipoprotein (LDL) (P = 0.005), and decrease in serum triglycerides (TG) (P = 0.046) were reported after CR. In the above-mentioned parameters, no differences were seen between the PTCA or CABG groups. Moreover, men and women benefited from CR programs to the same degree.

Conclusion: CR after PTCA or CABG significantly improved exercise capacity and cardiovascular risk factors. No significant differences were detected between these two groups. These preliminary data suggest that CR must be offered to cardiac patients and such courses must be accepted by insurance companies as an integrated medical program which cannot be ignored in the management of patients.