"Safety and Efficacy of Exercise-based Cardiac Rehabilitation in Patients with Refractory Angina: a Randomized, Controlled Trial"

AimEvidence is scarce regarding safety and anti-ischemic effects of exercise-based cardiac rehabilitation (ECR) in patients with refractory angina (RA). MethodsThis was a prospective, single-center, randomized controlled study that assessed a 12-week ECR program in patients with RA. Death and cardiovascular events, anginal symptoms, exercise stress echocardiogram (ESE) and cardiopulmonary exercise test (CPET) parameters were evaluated. When significant differences were detected, Bonferroni post hoc comparisons were conducted. ResultsNo difference regarding clinical events and anginal symptoms was found between groups. In ESE, rehab group (RG) increased in peak load (RGpost to RGpre, P = 0.001; interaction, P < 0.001), angina quantification (RGpost to RGpre, P = 0.004; control group (CG)pre than CGpost, P = 0.006; RGpost than CGpre, P = 0.0019; interaction, P = 0.001), exercise duration (RGpost to RGpre, P = 0.009; interaction, P = 0.006), ischemic threshold (RGpost to RGpre, P = 0.001; CGpre than CGpost, P = 0.03; RGpost than CGpre, P = 0.008; interaction, P = 0.005) and angina threshold (RGpost to RGpre, P = 0.04; RGpost than CGpost, P = 0.04; interaction, P = 0.002). In CPET, RG had increased exercise duration and covered distance in RGpost (RGpre than RGpost, P = 0.001; interaction, P = 0.014, RGpre than RGpost, P < 0.001; interaction, P < 0.01; respectively). ConclusionA 12-week ECR was safe and promoted positive clinical effects regarding exercise duration, intensity of angina, and angina and ischemic thresholds in RA patients. The trial registry: Cardiac Rehabilitation in Patients with Refractory Angina (NCT03218891)