Early Short-Term Intensive Cardiac Rehabilitation Induces Positive Results as Long as One Year after the Acute Coronary Event: A Prospective One-Year Controlled Study

Aims The one-year effects of early and short-term intensive cardiac rehabilitation programmes in patients after acute myocardial infarction or coronary artery bypass surgery (CABG) are not well established.

Methods and results One to four weeks after hospital discharge for acute myocardial infarction (n=55) or CABG (n=54), 109 patients were included in a multidisciplinary ambulatory cardiac rehabilitation programme, lasting 2 to 3 months and including a mean of 33 daily sessions. A complete cardiological assessment of the classical coronary risk factors was performed at entry into the study and again 12 months later, that is 9 to 10 months after the end of the rehabilitation programme. Major effects at one-year follow-up were a high rate of aspirin intake, a low rate of smoking (14% of the patients), a 15% increase in physical capacity, a 7 beats/min decrease in resting heart and a 4 mg/dl increase in the HDL-cholesterol. Body weight increased by 4.9 kg in the patients who stopped smoking; the modest increase in body weight in the other patients reflected a partial weight recovery in the CABG patients. Blood pressure levels also increased at the end of the study but our data in CABG patients and their extrapolation to the post MI patients strongly suggest a progressive return of blood pressure to the pre-acute event levels.

In a control group matched for age, sex and type of coronary event, no significant modifications were observed after one year, except for an increase in body weight of 1.7 kg (P < 0.000).

Conclusions Cardiac rehabilitation which started early after an acute coronary event and regularly followed during 2 to 3 months induced beneficial effects which were still present 9 to 10 months later. Weight gain after smoking cessation was prevalent. The lack of changes in the control group reinforced the benefit of cardiac rehabilitation.