Key result
Intensive physical activity around the time of PCI significantly improved maximal exercise capacity compared to usual care (27 vs 9 W, P=0.02), but did not affect metabolism or inflammation.
Why the study?
Does intensive physical activity improve exercise capacity, metabolism, and inflammation in patients undergoing elective PCI for stable angina?
RCT (n=62)
Does intensive physical activity improve exercise capacity, metabolism, and inflammation in patients undergoing elective PCI for stable angina?
Absolute Event Rate: 27% vs 9%
p-value: p=0.02
A home-based exercise program starting before and continuing after elective PCI improves maximal exercise capacity but does not significantly alter metabolic or inflammatory markers.
Supports peri-PCI exercise to enhance capacity in stable angina; confirms no metabolic or inflammatory effects.
OBJECTIVE: Physical activity is effective in primary and secondary prevention of cardiovascular disease. In this study, we tested the hypothesis that exercise training improves glucose and lipid metabolism, the inflammatory/anti-inflammatory balance, and the outcome of elective percutaneous coronary intervention (PCI) in patients with stable coronary disease. METHODS: Sixty-two patients scheduled to undergo PCI for stable angina were randomized to intensive physical activity (n=33) consisting of home-based exercise on a bicycle ergometer or maintain their usual sedentary life (n=29). The training program started 2 months before PCI and terminated 6 months afterwards. Clinical examination, blood sampling (fasting glucose, glycated hemoglobin, lipid profile, apolipoprotein B, apolipoprotein A1, C-reactive protein, serum amyloid A, interleukin-6, interleukin-8, and interleukin-10), and maximal exercise tests were performed at inclusion, 1 week before PCI, and 3 and 6 months afterwards. RESULTS: Fifty-six patients [28 per group, 45 men, mean age 63 (SD 7.8) years] completed the follow-up. According to self-reports, patients in the training group exercised more often and longer [4.9 (SD 1.1) vs. 0.6 (SD 1.3) days/week, 36 (SD 12) vs. 15 (SD 31) min/session, P<0.0001]. Improvement in maximal exercise capacity was significantly better in the training group [27 (SD 27) vs. 9 (SD 27) W, P=0.02]. Exercise had no significant effects on glucose and lipid metabolism, plasma cytokines, or acute-phase reactants. CONCLUSION: A home-based training program significantly improved maximal exercise capacity but did not affect glucose or lipid metabolism or markers of inflammation.
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Astengo et al. (2009) conducted an RCT in Stable angina (n=62). Intensive physical activity vs. Usual sedentary life was evaluated on Improvement in maximal exercise capacity (p=0.02). Intensive physical activity around the time of PCI significantly improved maximal exercise capacity compared to usual care (27 vs 9 W, P=0.02), but did not affect metabolism or inflammation.
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