Early Phase 2 Inpatient Rehabilitation after Acute Coronary Syndrome Treated with Primary Percutaneous Coronary Intervention Short- and Long-Term Effects on Blood Pressure and Metabolic Parameters

Deskur-Smielecka E, Borowicz-Bienkowska S, Maleszka M, Wilk M, Nowak A, Przywarska I, Dylewicz P: Early phase 2 inpatient rehabilitation after acute coronary syndrome treated with primary percutaneous coronary intervention: Short-and long-term effects on blood pressure and metabolic parameters. Am J Phys Med Rehabil 2011;90:589-598. Objective: The aim of this study was to assess the 1-yr follow-up effects of inpatient rehabilitation and its prolongation with an ambulatory training program on blood pressure and metabolic risk factors in patients after an acute coronary syndrome. Design: A controlled (n=20) prospective study was undertaken. The study group consisted of 54 consecutive patients participating in a 3-wk inpatient rehabilitation. Of these, 14 chose to continue the training for 3 mos (CR_In+Amb group) and 40 declined (CR_In group). Results: Body mass index increased in the CR_In and control groups. The magnitude of change was greater in controls (2.2 +/- 2.14 vs. 0.7 +/- 1.70 kg/m(2); P < 0.05). Waist circumference increased only in the control group, and at 12 mos, it was higher than in the CR_In and CR_In+Amb groups (P < 0.05). Mean systolic and diastolic blood pressure increased in the CR_In (from 121/76 to 130/82 mm Hg; P < 0.01) and control (from 122/74 to 139/87 mm Hg; P < 0.01) groups. At 12 mos, blood pressure in the CR_In group was lower than in the control group but higher than in the CR_In+Amb group (119/77 mmHg; P < 0.05). Total cholesterol, low-density lipoprotein cholesterol level, and triglyceride level at 12 mos were higher in the control group than in the CR_In and CR_In+Amb groups (P < 0.05). C-reactive protein decreased in the CR_In and CR_In+Amb groups (P < 0.01). Conclusions: Inpatient rehabilitation was associated with beneficial effects on blood lipids and C-reactive protein in coronary patients and attenuated the rise in blood pressure and adiposity indices observed in nonparticipants. Prolongation of rehabilitation with an ambulatory program improved blood pressure control.