Long-Term Results of High-Intensity Exercise-Based Cardiac Rehabilitation in Revascularized Patients for Symptomatic Coronary Artery Disease

Abstract

Exercise capacity is a strong predictor of survival rate in patients with and without coronary artery disease. Exercise-based cardiac rehabilitation (CR) with improvements in the peak oxygen uptake (VO_2peak) of 3.5 ml/kg/min or more has been shown to be beneficial in earlier observational studies. Long-term results on VO_2peak after CR are rare. The aim of this study was to assess if a 12-week outpatient CR program including high-intensity interval training would preserve or improve VO_2peak 15 months after CR entry. A total of 133 coronary patients attended the CR program (the Norwegian Ullevaal model). At baseline, at the end of the program, and after 15 months, the patients were evaluated with a cardiopulmonary exercise test, body mass index, blood pressure, self-reported exercise habits, and quality of life (the COOP-WONCA questionnaire). Long-term outcomes were available for 86 patients (65 %). The mean age was 57 ± 9 years and 87% were men. VO_2peak improved significantly from baseline (31.9 ± 7.6 ml/kg/min) to program end (35.9 ± 8.6 ml/kg/min) (p <0.001), and further progress was seen at the long-term follow-up (36.8 ± 9.2 ml/kg/min) (p <0.05). COOP-WONCA was significantly enhanced in all domains (p <0.001) with a meaningful clinical improvement in "physical fitness" from baseline to long-term follow-up. In conclusion, at follow-up, the patients still exercised (mean 2.5 ± 1 times per week) and had improved or preserved their VO_2peak and quality of life.