Hospital-based phase III cardiac rehabilitation program improves low density lipoprotein, triglyceride, and fasting blood glucose levels in coronary artery disease patients

Abstract

Cardiac rehabilitation (CR) is reported as effective program to improve coronary risk factors and increase exercise tolerance in patients with coronary artery disease (CAD) after cardiac events. Normally, the CR program is performed in 3 phases i.e. acute (phase I), subacute (phase II), and chronic (phase III). In Indonesia, the most CR programs were conducted using phase I and some phase II, whereas phase III CR program has not often been performed due to it is not covered by national health insurance. The aim of the study was to evaluate the effects of phase III comprehensive CR program on physical status and coronary risk factors among CAD patients. Seventy-four patients were stratified as the intervention group (n=37) and the control group (n=37). In the intervention group, patients participated in an hospital-based phase III CR program for 6 months, whereas in the control group, patients received a standard care. The CR program consists of warm-up, aerobic exercise, cool-down stretching, and health education session three days a week. Blood glucose level and lipid profile examinations were performed before and sixth month after the program implemented to assess patient's metabolic status. Among 74 patients involved in this study, most patients were male (85.1%) with mean age 54.7±3.4 years old. Fifty-seven patients had post-procedural history (77% post-PCI, 4% post-CABG), 8 patients (11%) were still active smokers, 31 patients (42%) had diabetes, and 60 patients (81%) had hypertension. Participation in the hospital-based phase III CR program was significantly correlated with lower low-density lipoprotein (LDL) level (p=0.003; r=0.41), triglyceride level (p=0.001; r=0.38), and fasting blood glucose level (p<0.001; r=0.46) during 6-month follow up. In conclusion, patients with CAD who undergo hospital-based phase III CR program have significantly better fasting glucose control, LDL, and triglyceride levels. These results may encourage other hospitals to perform the same program achieving better prognosis of CAD patients.