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Exercise training intervention after coronary angioplasty: the ETICA trial
Belardinelli R, Paolini I, Cianci G, Piva R, Georgiou D, Purcaro A
Journal of the American College of Cardiology 2001 Jun 1;37(7):1891-1900
clinical trial
7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The goal of this study was to determine the effects of exercise training (ET) on functional capacity and quality of life (QOL) in patients who received percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting (CS), the effects on the restenosis rate and the outcome. BACKGROUND: It is unknown whether ET induces beneficial effects after coronary angioplasty. METHODS: We studied 118 consecutive patients with coronary artery disease (mean age 57 +/- 10 years) who underwent PTCA or CS on one (69%) or two (31%) native epicardial coronary arteries. Patients were randomized into two matched groups. Group T (n = 59) was exercised three times a week for six months at 60% of peak VO2. Group C (n = 59) was the control group. RESULTS: Only trained patients had significant improvements in peak VO2 (26%, p < 0.001) and quality of life (26.8%, p = 0.001 versus C). The angiographic restenosis rate was unaffected by ET (T: 29%; C: 33%, p = NS) and was not significantly different after PTCA or CS. However, residual diameter stenosis was lower in trained patients (-29.7%, p = 0.045). In patients with angiographic restenosis, thallium uptake improved only in group T (19%; p < 0.001). During the follow-up (33 +/- 7 months) trained patients had a significantly lower event rate than controls (11.9 versus 32.2%, RR 0.71, 95% confidence interval (CI) 0.60 to 0.91, p = 0.008) and a lower rate of hospital readmission (18.6 versus 46%, RR 0.69, 95% CI 0.55 to 0.93, p < 0.001). CONCLUSIONS: Moderate ET improves functional capacity and QOL after PTCA or CS. During the follow-up, trained patients had fewer events and a lower hospital readmission rate than controls, despite an unchanged restenosis rate.
With permission from Excerpta Medica Inc.

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