Key result
High lifestyle adherence linked to ~236% greater likelihood of elevated EPC levels at 6 months.
Why the study?
The impact of adherence to lifestyle recommendations during a cardiac rehabilitation program on endothelial progenitor cells in acute myocardial infarction patients was unknown.
Does adherence to lifestyle recommendations improve endothelial progenitor cell levels and exercise capacity in AMI patients after a cardiac rehabilitation program?
Cohort (n=110)
Does adherence to lifestyle recommendations improve endothelial progenitor cell levels and exercise capacity in AMI patients after a cardiac rehabilitation program?
Odds Ratio: 3.36 (95% CI 1–10.72)
p-value: p=0.04
High adherence to lifestyle recommendations following cardiac rehabilitation is associated with increased endothelial progenitor cells and improved exercise capacity in patients with acute myocardial infarction.
High adherence may support vascular repair post-AMI rehab; hypothesis-generating and requires randomized trials before practice change.
An increase of endothelial progenitor cells (EPCs) among acute myocardial infarction (AMI) patients participating in a cardiac rehabilitation (CR) program has been reported, but no data on the impact of adherence to lifestyle recommendations provided during a CR program on EPCs are available. It was our aim to investigate the effect of adherence to lifestyle recommendations on EPCs, inflammatory and functional parameters after six months of a CR program in AMI patients. In 110 AMI patients (90 male/20 female; mean age 57.9 ± 9.4 years) EPCs, high sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-ProBNP) levels, and cardiopulmonary testings were determined at the end of the CR (T1) and at a six-month follow-up (T2). At T2 we administered a questionnaire assessing dietary habits and physical activity. At T2, we observed a decrease of EPCs (p<0.05), of hsCRP (p=0.009) and of NT-ProBNP (p<0.0001). Patient population was divided into three categories by Healthy Lifestyle (HL) score (none/low, moderate and high adherence to lifestyle recommendations). We observed a significant association between adherence to lifestyle recommendations, increase in EPCs and exercise capacity between T1 and T2 (Δ EPCs p for trend <0.05; ΔWatt max p for trend=0.004). In a multivariate logistic regression analyses, being in the highest tertile of HL score affected the likelihood of an increase of EPC levels at T2 [OR (95% confidence interval): 3.36 (1.0-10.72) p=0.04]. In conclusion, adherence to lifestyle recommendations provided during a CR program positively influences EPC levels and exercise capacity.
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Marcucci et al. (2014) conducted a cohort in Acute myocardial infarction (n=110). High adherence to lifestyle recommendations vs. None/low adherence to lifestyle recommendations was evaluated on Increase of endothelial progenitor cell (EPC) levels at 6-month follow-up (OR 3.36, 95% CI 1.0-10.72, p=0.04). Being in the highest tertile of adherence to lifestyle recommendations increased the likelihood of elevated endothelial progenitor cell levels at 6 months (OR 3.36; 95% CI 1.0-10.72; p=0.04).
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