Benefits of a Monitored Rehabilitation Program Versus Physician Care After Emergency Percutaneous Transluminal Coronary Angioplasty

To evaluate the effect 1of a monitored rehabilitation program on restenosis after successful emergency percutaneous transiuminal coronary angioplasty (PTCA), the authors compared the results of a rehabilitation group (N = 60) with a matched group (N = 68) of patients who received the usual post-PTCA care provided by their physician or cardiologist. The rehabilitation group trained for 12 weeks, 2 to 3 times/week for 45 to 60 minutes each on a variety of stationary equipment at a heart rate of 70 to 85% of the age-predicted maximum. They also underwent an 8-session educational program and 6 months follow-up of risk factors for secondary prevention of coronary artery disease (CAD). Because the majority of patients who restenose do so during the first 6 months after PTCA, the study was terminated 5 ± 1 months after the procedure. Between groups comparison after 5.5 ± 1 months showed: 1) significantly (T < 0.001) lower cholesterol and low density lipoprotein levels for the rehabilitation group; 2) significantly (P < 0.001) higher physical work capacity (Mets), high density lipoprotein (P < 0.001), and ejection fraction (T < 0.05) for the rehabilitation group; 3) no group differences in body weight, number of smokers, and patients with clinically treated hypertension; and 4) no group difference in rate of restenosis; 30 and 32% for the rehabilitation and physician care, respectively. Thus, our finding does not show a relationship between significantly higher ejection fraction, work capacity and improvement in lipid profile and rate of restenosis after emergency PTCA.