A 12-week cardiovascular rehabilitation program significantly reduced median CRP from 1.9 mg/L to 1.0 mg/L in patients with coronary artery disease (p<0.001).
Cohort (n=1,432)
Does a 12-week cardiovascular rehabilitation program reduce c-reactive protein levels in patients with coronary artery disease?
A 12-week cardiovascular rehabilitation program significantly reduces systemic inflammation (CRP) in patients with coronary artery disease, and this reduction is independently associated with improvements in exercise capacity.
Absolute Event Rate: 1% vs 1.9%
p-value: p=<0.001
Abstract Background/Introduction Systemic low-grade inflammation is associated with an increased risk of major cardiovascular events (MACE) and greater healthcare utilisation in patients with coronary artery disease (CAD). Pharmacological therapies directly targeting inflammation have demonstrated significant reductions in MACE. However, they can be expensive and can have potentially fatal side effects. Purpose We investigated the impact of cardiovascular rehabilitation (CR) on c-reactive protein (CRP) and aimed to characterise patients with elevated CRP (≥ 2mg/L) post-CR in a large contemporary cohort. Methods In this observational cohort study, we analysed patients with chronic or acute CAD who completed a standardised 12-week outpatient CR-program. Patient characteristics as well as laboratory and clinical parameters including results from cardiopulmonary exercise testing were recorded at baseline and after completing CR. Results In total 1432 patients were included. Median CRP decreased from 1.9 mg/L (IQR 0.9-4.7 mg/L) to 1.0 mg/L (IQR 0.5-2.0 mg/L) during CR (p 0.001). CRP reductions were significant across all predefined categories of LDL-C, kidney function, body mass index and smoking status (all p 0.05). Post-CR 24.9% of all patients and 21.8 % of those with low-density lipoprotein cholesterol (LDL-C) 1.4 mmol/L had elevated CRP. Reductions in CRP were independently associated with improvements in exercise capacity after adjusting for age, sex, changes in body mass index, LDL-C and smoking status during CR (β = -0.05, p = 0.010 for peak oxygen uptake in ml/min/kg; β = -0.01, p 0.001 for peak workload in watts). Conclusions In this large, present-day cohort of CAD patients CRP was significantly reduced during CR across diverse patient profiles. Improvements of cardiorespiratory fitness were directly associated with a reduction of systemic inflammation. Exercise-based CR therefore represents a promising therapeutic strategy for patients with residual inflammatory risk. Despite these benefits, residual inflammation remained common, even among patients achieving guideline-recommended LDL-C levels. We identified certain subgroups who could potentially benefit from additional anti-inflammatory strategies after CR such as targeted pharmacotherapy.
Meier et al. (Mon,) conducted a cohort in Coronary artery disease (n=1,432). Cardiovascular rehabilitation vs. Baseline (pre-rehabilitation) was evaluated on C-reactive protein (CRP) level (p=<0.001). A 12-week cardiovascular rehabilitation program significantly reduced median CRP from 1.9 mg/L to 1.0 mg/L in patients with coronary artery disease (p<0.001).