Effects of cardiac rehabilitation on fibrinolysis in patients with coronary artery disease.

ABSTRACT

The aim of the present study was to demonstrate the influence of exercise component of a cardiac rehabilitation program on fibrinolysis in coronary artery disease (CAD) patients. Cardiac rehabilitation program was claimed to have an important role for improving quality of life and reducing the incidence of recurrent disease. The program used in the present study included aerobic exercise for 8 weeks, 4 days per week, 30 minutes per day at light to moderate intensity. Thirty-three male patients with CAD were recruited in the present study. Subjects from Thammasat University Hospital and King Chulalongkorn Memorial Hospital, whose age ranging from 40 to 70 years, were random assigned into 2 groups control and experimental groups. The results showed that no significant differences in tissue plasminogen activator levels (t-PA) (both antigen and activity), plasminogen activator inhibitor-1 levels (PAl-1) (both antigen and activity) were observed in control and experimental groups after exercise training for 8 weeks as compared to the baseline. However significant improvement of fibrinolysis via a decrease in PAI-1 activity level from 16.3 (3.7) to 14.8 (6.3) AU/ml (p < 0.024) and an increase in t-PA activity from 2.3 (0.8) to 2.7 (0.5) IU/ml and t-PA antigen from 7.5 (2.9) to 9.2 (2.7) ng/ml (p < 0.01) in experimental group were observed when compared between pre and post acute submaximum exercise (65% VO(2 peak)) at the end of the program. In addition the authors found a significant improvement in VO(2 peak) resting heart rate, and serum triglyceride level in experimental group after 8 weeks of exercise training. This study demonstrated that patients with CAD participating in 8 weeks exercise cardiac rehabilitation program at light--moderate intensity could improve physical fitness and physical health although there was no significant change of fibrinolysis. The CAD patients should be advised to enroll in this cardiac rehabilitation program since it did not have any harmful effect due to the fibrinolytic function but it also augmented the patients' physical health.