Impact of Exercise-Based Cardiac Rehabilitation on Metabolic Syndrome in Post-Acute Coronary Syndrome Patients

Abstract

Abstract Background Metabolic syndrome (MetS) is characterized by a cluster of cardiovascular risk factors including hypertension (HTN), impaired fasting blood sugar (FBS), increased central obesity (WC) and dyslipidemia; hypertriglyceridemia (TG) and low high-density lipoprotein- cholesterol (HDL-C). The MetS adversely affects cardiovascular outcomes, individuals with at least 4 out of 5 features of MetS have a 3.7-fold increased risk of coronary artery diseases at a 5-year follow-up. Objective to determine the effectiveness of exercise based-cardiac rehabilitation (CR) program on MetS in post-Acute Coronary Syndrome (ACS) patients versus guideline directed medical therapy over a 12 weeks period. Patients and Methods The study included 62 patients who suffered from ACS with evidence of MetS. All patients were recruited from Ain Shams University Hospitals (ASUHs) from July 2021 to December 2021 and were assessed at baseline and after 12 weeks of follow up for MetS parameters. After approval by the local ethics committee all patients were provided voluntary informed consent. The study subjects were classified into two groups: Group A (case group): included 32 patients who completed at least 80% of 12 weeks of CR program in ASUHs. Group B (control group): included 30 patients who did not attend the CR program and completed 12 weeks of guideline directed medical therapy alone. Results The results revealed that -when compared group A at baseline and after 12 weeks of CR-program there was a significant reduction in WC, FBS and TG levels, while there was a significant rise in HDL-C level. However, there was no statistically significant difference found regarding BP in this group. Regarding group B there was no statistically significant difference between the baseline MetS parameters and at follow up after 12 weeks of guideline directed medical therapy alone. Conclusion The present study revealed that there was a statistically significant improvement regarding WC, FBS, TG and HDL after completion of 12 weeks of the CR Program, while there was no statistically significant difference found regarding BP in the study group. In the control group there was no statistically significant difference found at baseline and follow up after 12 weeks of guideline directed medical care alone. Thus, the exercise-based CR program is superior than the regular medical care alone in improving the WC, FBS, TG and HDL. Key words: Metabolic Syndrome, Cardiac Rehabilitation, Exercise Training, ACS. Abbreviations and Acronyms. Acronyms: ACS: Acute Coronary Syndrome ASUHs: Ain Shams University Hospitals BP: Blood Pressure CR: Cardiac Rehabilitation FBS: Fasting Blood Sugar HDL-C: High Density Lipoprotein-Cholesterol HTN: Hypertension MetS: Metabolic Syndrome TG: Triglyceridemia WC: Central Obesity