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Published on: May 14, 2013
Exercise training is safe after coronary stenting: a prospective multicentre study
Marie-Christine Iliou1, Bruno Pavy2, Jimena Martinez3
1Hôpital Corentin Celton, Issy les Moulineaux, France marie-christine.iliou@ccl.aphp.fr.
Insights
Exercise training after coronary stenting is safe, with a low rate of acute coronary syndrome (ACS). Early or delayed cardiac rehabilitation shows no increased risk, supporting prompt program initiation.
Area of Science:
- Cardiology
- Exercise Physiology
- Public Health
Background:
- Limited data exists on the safety of exercise training post-coronary stenting.
- Coronary stenting is a common procedure, necessitating understanding of post-procedural care.
- Cardiac rehabilitation plays a crucial role in patient recovery and long-term health.
Purpose of the Study:
- To evaluate the safety of exercise training in patients who have undergone coronary stenting.
- To determine the incidence of acute coronary syndrome (ACS) related to exercise sessions after stenting.
- To compare the safety of early versus late initiation of cardiac rehabilitation.
Main Methods:
- Prospective cohort study involving 3132 patients within 12 months of coronary stenting.
- Patients participated in a cardiac rehabilitation program with 3-5 weekly training sessions.
- Acute coronary syndrome (ACS) occurrence was tracked relative to exercise sessions, with all events confirmed by angiography.
Main Results:
- The study included 3132 patients (84.7% men, mean age 56.5 years) with 5016 stents implanted.
- The overall rate of ACS post-stenting was 2.9 per 1000 patients (1.7 per 10^6 patient-hours of exercise).
- Four exercise-related stent thromboses occurred (1.2 per 1000 patients), two in early and two in late rehabilitation groups.
Conclusions:
- Exercise training following coronary stenting appears to be safe.
- There is no evidence to support delaying cardiac rehabilitation after coronary stenting.
- Prompt initiation of exercise-based cardiac rehabilitation is advisable for patients post-stenting.
Background:
Data on the safety of exercise training after coronary stenting are scarce.
Design:
This is a prospective cohort study of 3132 patients with coronary stenting within the last 12 months, recruited by 44 cardiac rehabilitation centres; patients were included in a cardiac rehabilitation programme with training sessions 3-5 days a week. Cardiac rehabilitation was defined as early rehabilitation when starting <1 month after coronary stenting and as late rehabilitation when starting later.
Methods:
Rate of acute coronary syndrome (ACS) after coronary stenting was estimated according to time to training session. ACS was defined as related to exercise when it occurs during or within the hour after an exercise stress test or a training session. All ACS were documented by an angiographic control.
Results:
Overall 5016 stents (41.4% drug-eluting stents) were implanted in 3132 patients aged 56.5 ± 12.9 years (84.7% men) with a median of 1 stent (range 1-8) per patient. Indication of coronary senting was ACS (86.4%), angina pectoris (8.6%), and silent ischaemia (5%). Combined antiplatelet treatment was used in 97.2% of the patients. Overall rate of ACS after coronary stenting was 2.9/1000 patients, corresponding to 1.7 complications out of 10(6) patient-hours of exercise. There were four stent thromboses related to exercise (1.2/1000 patients, 0.8/10(6) patient-hours of exercise): two in the early rehabilitation group (days 9 and 11), and two in the late rehabilitation group (days 77 and 228).
Conclusions:
Exercise training seems safe and there is no justification to delay cardiac rehabilitation after coronary stenting.
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