Exercise in outpatient complex rehabilitation and secondary prophylaxis in patients with ischemic heart disease after acute coronary events (a cooperative trial in Russia)

• Published in: Terapevtic̆eskii arhiv Vol. 78; no. 9; p. 33
• Main Authors: Aronov, D M, Krasnitskiĭ, V B, Bubnova, M G, Posdniakov, Iu M, Ioseliani, D V, Shchegol'kov, A N, Efremushkin, G G, Osipova, I V, Guliaeva, S F, Mal'chikova, S V, Kazakevich, E V, Liamina, N P, Riamzina, I N, Mingazetdinova, L N
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2006
• Subjects: Echocardiography; Electrocardiography; Exercise Therapy - methods; Female; Follow-Up Studies; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Middle Aged; Myocardial Ischemia - epidemiology; Myocardial Ischemia - prevention & control; Myocardial Ischemia - rehabilitation; Outpatients; Prevalence; Russia - epidemiology; Stroke Volume; Treatment Outcome; Ventricular Function, Left - physiology
• ISSN: 0040-3660

To assess efficacy of early and long-term exercise in patients with ischemic heart disease (IHD) after acute coronary events (acute myocardial infarction--AMI, unstable angina--UA, coronary artery bypass grafting--CABG) in wide outpatient medical practice of Russia. Three to eight weeks after the acute coronary event (ACE) 373 patients from different clinics of RF regions were randomized into two groups: the study group (n = 188) and a control one (n = 185). Both groups received standard therapy, the study group performed also a special exercise program (moderate exercise for maximum 1 hour 3 times a week for a year). The efficacy of the treatment was assessed by clinical, device and biochemical findings during 6-month follow-up. Physical work capacity, total amount of performed work (PW) in stress test rose in the study group by 26.5% (p < 0.01) and 59.4% (p < 0.01), respectively; HRmax and BPSmax x HRmax increased by 6.4 and 9.8%, respectively, p < 0.01); PW/Hrpeak rose by 48.6% (p < 0.01), PW/DP peak--by 45.9% (p < 0.01). Left ventricular ejection fraction increased by 5.6% (p < 0.05), LV stroke volume--by 3.4% (p < 0.05). In 6 months, controls demonstrated a 4.7% (p < 0.05) rise in HDLP cholesterol, total cholesterol lowered in the study group by 6.4% (p < 0.01), body mass index--by 1.9%, number of anginal attacks--by 0.9%. The proposed exercise program is effective and can be applied in outpatients after acute coronary events. The program can be also used as a method of secondary prophylaxis as it lowers total cholesterol, atherogenic index and body mass index.