Regular exercise training compared with percutaneous intervention leads to a reduction of inflammatory markers and cardiovascular events in patients with coronary artery disease

BACKGROUND: Chronic vascular inflammation may trigger ischemic events whereas regular physical exercise training (ET) has shown to be cardioprotective in patients with coronary artery disease (CAD). We investigated the impact of 2 years regular ET versus percutaneous intervention (PCI) on chronic inflammation and cardiovascular events. METHODS AND RESULTS: A total of 101 male patients with stable CAD and an indication for revascularization were prospectively randomized to regular ET (n=51) or PCI with stentimplantation (n=50). High-sensitive C-reactive protein and interleukin-6, exercise capacity and ischemic endpoints were analyzed at baseline and after 2 years. At 2 years maximal oxygen consumption (VO2 max) increased by 10% in the ET group (23.3+/-0.6 to 25.7+/-1.0 ml O2/kg/min; P=0.0171 versus baseline) versus 7% in the PCI group (22.3+/-0.8 to 23.9+/-1.2 ml O2/kg/min; P=0.4248). In a subgroup of patients, high-sensitive C-reactive protein levels and interleukin-6 levels were significantly reduced after ET by 41 and 18%, respectively, whereas no relevant changes were observed in the PCI group. Event-free survival rates after 24 months were 78% (ET) versus 62% (PCI) (P=0.039). CONCLUSION: In patients with stable coronary artery disease, regular physical exercise is associated with a reduction of inflammatory markers and ischemic events.