Changes in lipid and apolipoprotein levels in response to 8-week cardiac rehabilitation in men with coronary artery disease.

ABSTRACT

Concentrations of selected lipoproteins are currently useful cardiovascular risk assessment indicators, especially in monitoring lipid-lowering therapy. AIM: The aim was to evaluate the influence of 8-week mid-term CR on apolipoproteins A-I, B, E and VLDL in CAD patients in relation to conventional lipid profile and prior coronary intervention PCI or CABG. MATERIALS AND METHODS: 93 male patients admitted to CR after PCI or CABG. At baseline and after CR, conventional lipid profile parameters and VLDL concentrations were evaluated. Apolipoproteins A-I, B, E were also determined. Basic anthropometric indicators and measurements of hemodynamic and exercise tolerance at rest and peak workload in exercise testing (HR, sBP, dBP, DP, W) were measured. RESULTS: After CR, depending on revasculazation intervention, no changes in HDL-C, LDL-C, TG and VLDL values were observed (p>0.05). Reduction in apoA-I was noted in PCI group (p=0.0254). No statistically significant changes in apoB and apoE were found in groups. Significant increase in apo B/apo A-I index was observed only in PCI group (p=0.0329). PCI and CABG patients did not differ in hemodynamic and exercise tolerance parameters, except sBP in rest and dBP at peak workload in exercise testing (p=0.014 and p=0.031). Regardless on type of intervention, there was observed statistically significant increase in Wpeak (p=0,0000 in both groups) and DPpeak (p=0.0000 in PCI-patients and p=0.0003 in CABGpatients) after CR. CONCLUSIONS: CR has various effects on lipid concentrations. Indicators of conventional lipid profile and selected apolipoproteins are not optimal parameters allowing assessment of effectiveness of CR program in such a short time, this role is well fullfilled by the hemodynamic and physical exercise indices. Apo B/apo A-I ratio value suggests an increasing risk of IHD complications, especially in post- PCI group. CR program requires intensification of lipid-reducing therapy and education on lifestyle modification.