A 52-week structured exercise-based cardiac rehabilitation program improved LVEF (+5.0% vs. +4.0%, p=0.023) and reduced LDL-C compared to GDMT alone in patients with HFmrEF post-PCI.
RCT (n=120)
1:1
No
Does a 52-week structured exercise-based cardiac rehabilitation program improve LDL-C, TG, LVEF, and LVEDD in stable CAD patients with HFmrEF post-PCI?
A 52-week structured exercise-based cardiac rehabilitation program provides incremental benefits in LVEF recovery and LDL-C reduction beyond GDMT alone in stable CAD patients with HFmrEF post-PCI.
Absolute Event Rate: 5% vs 4%
p-value: p=0.023
BACKGROUND Exercise-based cardiac rehabilitation (ExCR) is standard for secondary prevention in coronary artery disease (CAD), yet its efficacy in patients with heart failure with mildly reduced ejection fraction (HFmrEF) after percutaneous coronary intervention (PCI) remains unclear. METHODS In this single-center RCT, 120 stable CAD patients with HFmrEF (LVEF 40-49%) post-PCI were randomized 1:1 to receive either guideline-directed medical therapy (GDMT) plus a 52-week structured ExCR program (intervention) or GDMT alone (control). Primary outcomes-LDL-C, TG, LVEF, and LVEDD-were assessed at 4, 12, 24, and 52 weeks. Linear Mixed Models analyzed longitudinal intervention effects. RESULTS A significant Group × Time interaction was observed for LVEF (p = .032), indicating superior recovery in the ExCR group. At 52 weeks, the ExCR group showed greater improvement in LVEF (+5.0% vs. +4.0%, p = .023) and greater reduction in LDL-C (-1.43 mmol/L vs. -1.04 mmol/L, p = .030) versus control. No between-group differences were found in TG or LVEDD. CONCLUSIONS A 52-week structured ExCR program significantly enhances cardiac recovery and lipid control in HFmrEF patients post-PCI, providing incremental benefits beyond GDMT alone. Sustained ExCR should be considered essential in comprehensive management for this population.
Cai et al. (Sat,) conducted a rct in Coronary artery disease with mildly reduced ejection fraction (HFmrEF) post-PCI (n=120). Guideline-directed medical therapy (GDMT) plus a structured exercise-based cardiac rehabilitation (ExCR) program vs. GDMT alone was evaluated on Improvement in LVEF at 52 weeks (p=0.023). A 52-week structured exercise-based cardiac rehabilitation program improved LVEF (+5.0% vs. +4.0%, p=0.023) and reduced LDL-C compared to GDMT alone in patients with HFmrEF post-PCI.