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

UNLABELLED: 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.