OBJECTIVE: To establish the benefits of an early, tailored and low-cost exercise intervention in older patients hospitalised for acute coronary syndrome (ACS). METHODS: The study was a multicentre, randomised assessment of an exercise intervention in patients with ACS >= 70 years with reduced physical performance (as defined by the short physical performance battery (SPPB), value 4 to 9). The exercise intervention included four supervised sessions (1, 2, 3, 4 months after discharge) and home-based exercises. The control group attended a health education programme only. The outcomes were the 6-month and 1-year effects on physical performance, daily activities, anxiety/depression and quality of life. Finally, 1-year occurrence of adverse events was recorded. RESULTS: Overall, 235 patients with ACS (median age 76 (73 to 81) years) were randomised 1 month after ACS. Exercise and control groups were well balanced. Exercise intervention improved 6-month and 1-year grip strength and gait speed. Exercise intervention was associated with a better quality of life (as measured by EuroQol-visual analogue scale at 6 months 80 (70 to 90) versus 70 (50 to 80) points, p < 0.001 and at 1 year 75 (70 to 87) versus 65 (50 to 80) points, p < 0.001) and with a reduced perception of anxiety and/or depression (6 months: 21% versus 42%, p = 0.001; 1 year 32% versus 47%, p = 0.03). The occurrence of cardiac death and hospitalisation for cardiac cause was lower in the intervention group (7.5% versus 17%, p = 0.04). CONCLUSIONS: The proposed early, tailored, low-cost exercise intervention improves mobility, daily activities, quality of life and outcomes in older patients with ACS. Larger studies are needed to confirm the clinical benefit. TRIAL REGISTRATION NUMBER: NCT03021044.
Reproduced with permission from the BMJ Publishing Group.

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