Comparison of the effects of the time of home-based cardiac rehabilitation program on the changes in cardiometabolic risk factors in patients with phase-IV myocardial infarction: A randomized controlled trial.

BACKGROUND: It seems that the time of performing cardiac rehabilitation is important in determining the risk of cardiac complications in patients with myocardial infarction (MI). The present study aimed to investigate the effects of a home-based cardiac rehabilitation program (HCRP) conducted in either the morning or evening on cardiometabolic risk factors in phase IV (maintenance) MI patients. METHODS: In this randomized controlled clinical trial, 80 patients with MI were divided into 2 groups of intervention and control (40 individuals per group). Patients in each group were categorized into morning and evening subgroups (20 individuals per subgroup). The therapeutic regimen in the intervention group included HCRP, routine medications, and exercise and walking programs for 8 weeks. Patients in the control group received routine treatments for 8 weeks. Cardiovascular risk factors comprising of cardiac troponin I (cTnI), mean platelet volume (MPV), C-reactive protein (CRP), and cardiometabolic indicators including cholesterol (Cho), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and the maximum rate of oxygen consumption (VO2 max) were measured for all patients before and after the intervention. RESULTS: Our results showed significant reductions in Cho, TG, HDL, LDL, VO2 max, CRP, and MPV (P < 0.05) in the group performing HCRP in the evening compared with the morning group. CONCLUSION: Performing HCRP in the evening, compared with morning, can be significantly more effective in improving the levels of cardiometabolic risk factors in patients with MI. Therefore, it is recommended that rehabilitation programs be implemented in these patients in evening shifts.