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| Effects of physical prehabilitation on the dynamics of the markers of endothelial function in patients undergoing elective coronary bypass surgery |
| Argunova Y, Belik E, Gruzdeva O, Ivanov S, Pomeshkina S, Barbarash O |
| Journal of Personalized Medicine 2022 Mar;12(3):471 |
| clinical trial |
| 6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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Our aim in this study was to evaluate the effect of physical training performed before CABG on the perioperative dynamics of the serum levels of asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1) of patients with stable coronary heart disease (CHD). Patients in the preoperative period were randomized into two groups: the training group (n = 43) underwent high-intensity treadmill training; the patients in the control group (n = 35) received no training before the procedure. The serum concentrations of ADMA and ET-1 were determined in the perioperative period, and the course of the early postoperative period was analyzed. In the training group, we found a significantly lower incidence of postoperative complications during hospital stays (p = 0.013). At the end of the training program, the ADMA levels were 1.8 times higher in the controls than in the training group (p = 0.001). We found that type 2 diabetes increased the probability of complications by 12 times (OR 12.3; 95% CI 1.24 to 121.5; p = 0.03), as well as elevating the concentration of ET-1 on the eve of surgery (OR 10.7; 95% CI 1.4 to 81.3; p = 0.02). Physical prehabilitation reduced the likelihood of complications nine times (OR 0.11; 95% CI 0.02 to 0.83; p = 0.03). The AUC was 0.851 +/- 0.07 (95% CI 0.71 to 0.98). The obtained results indicate the benefit of physical training during the prehabilitation stage since it can help to preserve endothelial function.
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