The effects of centre-based rehabilitation after acute myocardial infarction on exercise capacity and risk factors for coronary heart disease

Abstract

Background Rehabilitation following acute myocardial infarction (AMI) is a crucial part of secondary prevention for coronary heart disease. The aim of our study was to determine the efficiency of our national in-patient rehabilitation program in improving exercise capacity and lowering risk factors for coronary heart disease. Methods 25 patients 3-9 weeks after AMI, undergoing 2 week in-patient cardiac rehabilitation, were included in our study. We performed exercise stress testing and measurement of classic risk factors before and after the rehabilitation. Classic risk factors were compared with 25 age matched adults without known risk factors for coronary heart disease. Results Patients after AMI had lower exercise capacity than healthy adults (p≤0.002 for double product, maximal load, systolic blood pressure, heart rate and time of load). Patients recieved appropriate drug therapy after myocardial infarction, which presented as lower diastolic and a trend to lower systolic blood pressure (p=0.002 and 0.080), lower total and LDL cholesterol values (both p<0.001) than healthy adults, but higher values of metabolic syndrome parameters (higher waist cifcumference p=0.045, higher hip-waist ratio, lower HDL cholesterol, both p<0.001, and a trend to higher body mass index). Although we observed significant increases in exercise capacity (higher, maximal load, systolic blood pressure,double product and time of load, all p≤0.003), no changes in classic risk factors during rehabilitaiton were demonstrated. Conclusions In-patient program of cardiac rehabilitation efficiently elevates exercise capacity in patients after AMI, but fails to influence classic risk factors for coronary heart disease, which might be due to lack of controlled cardioprotective diet during rehabilitation.