BACKGROUND: The effects of adding moderate-to-high intensity inspiratory muscle training (IMT) to short-term aerobic and resistance exercise (combined training (CT)), after coronary artery bypass grafting (CABG) are not established. This study aimed to determine the effects of moderate-to-high intensity IMT+CT on exercise capacity, respiratory muscle strength, inspiratory muscle endurance, quality of life (QoL), and laboratory biomarkers in patients after CABG who were participants of a phase II cardiac rehabilitation program. METHODS: Twenty-four patients were randomly assigned to either the IMT+CT group (n = 12), who performed moderate-to-high intensity IMT with CT or the sham-IMT+CT group (n = 12). Patients completed two sessions per week for 12 weeks. Each patient underwent a cardiopulmonary exercise test, six-minute walk test (6MWT), respiratory muscle strength and endurance evaluation, QoL questionnaire, and serum advanced oxidation protein products, ferric reducing antioxidant power (FRAP), nitrate/nitrate, and high-sensitivity c-reactive protein, before and after the 12-week intervention. RESULTS: The IMT+CT group showed significantly greater improvements in peak oxygen uptake (1.3 mL/kg/min); 95% confidence interval (95% CI) 0.5 to 2.2), distance covered during the 6MWT (78.8m; 95% CI 28.1 to 129.5), maximal inspiratory pressure (23.0 cmH2O; 95% CI 9.3 to 36.7), QoL (-15.1 points; 95% CI -26.9 to -3.3), and FRAP (83.7mumol/L; 95% CI 20.2 to 147.1) compared to the sham-IMT+CT group as a result of the intervention. CONCLUSIONS: Short-term moderate-to-high intensity IMT with CT provided additional benefits in exercise capacity, inspiratory muscle strength, QoL, and antioxidant profile in patients after CABG. Trial Registration: NCT02885077.

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