“Safety and Efficacy of Exercise-based cardiac rehabilitation in patients with refractory angina: a randomized, controlled trial”

Aim Evidence is scarce regarding safety and anti-ischemic effects of exercise-based cardiac rehabilitation (ECR) in patients with refractory angina (RA). Methods This was a prospective, single-center, randomized controlled study that assessed a 12-week ECR program in patients with RA. Death and cardiovascular events, anginal symptoms, exercise stress echocardiogram (ESE) and cardiopulmonary exercise test (CPET) parameters were evaluated. When significant differences were detected, Bonferroni post hoc comparisons were conducted. Results No difference regarding clinical events and anginal symptoms was found between groups. In ESE, rehab group (RG) increased in peak load (RG post to RG pre , P = 0.001; interaction, P < 0.001), angina quantification (RG post to RG pre , P = 0.004; control group (CG) pre than CG post , P = 0.006; RG post than CG pre , P = 0.0019; interaction, P = 0.001), exercise duration (RG post to RG pre , P = 0.009; interaction, P = 0.006), ischemic threshold (RG post to RG pre , P = 0.001; CG pre than CG post , P = 0.03; RG post than CG pre , P = 0.008; interaction, P = 0.005) and angina threshold (RG post to RG pre , P = 0.04; RG post than CG post , P = 0.04; interaction, P = 0.002). In CPET, RG had increased exercise duration and covered distance in RG post (RG pre than RG post , P = 0.001; interaction, P = 0.014, RG pre than RG post , P < 0.001; interaction, P < 0.01; respectively). Conclusion A 12-week ECR was safe and promoted positive clinical effects regarding exercise duration, intensity of angina, and angina and ischemic thresholds in RA patients. The trial registry: Cardiac Rehabilitation in Patients with Refractory Angina ( NCT03218891 )