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More Leisure-time Physical Activity Results in Less Short-term Cardiovascular Risk in CAD Patients

Both patients with and without diabetes but with thrice-weekly physical activity had reduced risk of cardiovascular events compared with patients with reduced physical activity….

Leisure-time physical activity (LTPA) and exercise training are essential parts of current guidelines for patients with coronary artery disease (CAD). However, the contributions of LTPA and exercise training to cardiovascular (CV) risk in CAD patients with type 2 diabetes (T2D) are not well established.

Finnish researchers examined the effects of LTPA (n = 539 and n = 507; with and without T2D, respectively) and 2-year controlled, home-based exercise training (n = 63 plus 64 control subjects with T2D and n = 72 plus 68 control subjects without T2D) on the CV risk profile and composite end point among CAD patients.

The results showed that during the 2-year follow-up, patients with reduced LTPA at baseline had an increased risk of CV events (adjusted hazard ratio 2.3 [95% CI 1.1-5.1; P = 0.033], 2.1 [1.1-4.2; P = 0.027], and 2.0 [1.0-3.9; P = 0.044] for no LTPA, LTPA irregularly, and LTPA two to three times weekly, respectively) compared with those with LTPA more than three times weekly. Among patients who completed the 2-year exercise intervention, exercise training resulted in favorable changes in exercise capacity both in CAD patients with T2D (+0.2 ± 0.8 vs. -0.1 ± 0.8 MET, P = 0.030) and without T2D (+0.3 ± 0.7 vs. -0.1 ± 0.5 MET, P = 0.002) as compared with the control group but did not have any significant effects on major metabolic or autonomic nervous system risk factors in CAD patients with or without T2D.

The researchers concluded that, there is an inverse association between habitual LTPA and short-term CV outcome, but controlled, home-based exercise training has only minor effects on the CV risk profile in CAD patients with T2D.

Practice Pearls:

  • Researchers evaluated 1046 patients with coronary artery disease and with or without type 2 diabetes to determine the association of leisure-time physical activity on cardiovascular risk.
  • Patients with thrice weekly physical activity had reduced risk of cardiovascular events compared with patients with reduced physical activity.
  • Exercise capacity was improved in patients with and without diabetes following an exercise training plan.
  • Findings suggest that physical activity and exercise offers benefits in patients with coronary artery disease with or without diabetes.

Published online before print January 15, 2015, doi: 10.2337/dc14-2216 Diabetes Care January 15, 2015