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Stent edge vascular response and in-stent geometry after aerobic exercise
Maria Dalen Taraldsen1, Vibeke Videm2,3, Knut Hegbom4
1Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. mariadt_91@hotmail.com.
Cardiovascular Intervention and Therapeutics
|March 11, 2020
Summary
Aerobic exercise, including aerobic interval training (AIT), reduced plaque burden and necrotic core content at distal stent edges in patients with drug-eluting stents (DES). AIT showed greater plaque reduction compared to moderate continuous training (MCT).
Area of Science:
- Cardiology
- Exercise Physiology
- Biomedical Engineering
Background:
- Drug-eluting stents (DES) are crucial in treating coronary artery disease (CAD).
- Understanding vascular response at stent edges post-intervention is vital for long-term outcomes.
- Aerobic exercise interventions are increasingly explored for cardiovascular health management.
Purpose of the Study:
- To investigate the impact of a 3-month aerobic exercise intervention on vascular response at stent edges in patients treated with DES.
- To compare the effects of aerobic interval training (AIT) versus moderate continuous training (MCT) on plaque characteristics.
Main Methods:
- Thirty-two patients with significant CAD receiving DES implantation were randomized into AIT (14 patients) or MCT (18 patients) groups.
- Intravascular ultrasound (IVUS) was used to assess plaque changes (burden and necrotic core) at proximal and distal stent edges at baseline and follow-up.
- Primary endpoints focused on changes in plaque burden and necrotic core content within the 5-mm segments proximal and distal to the stent.
Main Results:
- Significant reduction in plaque burden was observed in the distal stent edges for both AIT (-3.3%) and MCT (-0.4%) groups (p=0.01).
- The AIT group demonstrated a significantly greater reduction in distal plaque burden compared to the MCT group (p=0.048).
- Necrotic core content significantly decreased in distal stent edges for both AIT (-2.1 mm³) and MCT (-0.3 mm³) (p=0.01), with a more pronounced effect in the AIT group (p=0.03). No significant changes were noted in proximal edges or in-stent geometry.
Conclusions:
- Three months of aerobic exercise, particularly AIT, can effectively reduce plaque burden and necrotic core content at the distal edges of DES.
- AIT may offer superior benefits over MCT in mitigating plaque accumulation and composition changes around DES.
- These findings suggest exercise interventions as a valuable adjunct therapy for patients with DES.
