Article

Data on the safety of exercise training after coronary stenting are scarce. DESIGN: This is a prospective cohort study of 3132 patients with coronary
stenting within the last 12 months, recruited by 44 cardiac rehabilitation
centres; patients were included in a cardiac rehabilitation programme with
training sessions 3-5 days a week. Cardiac rehabilitation was defined as early
rehabilitation when starting
<1 month after coronary stenting and as late
rehabilitation when starting later. METHODS: Rate of acute coronary syndrome
(ACS) after coronary stenting was estimated according to time to training
session. ACS was defined as related to exercise when it occurs during or within
the hour after an exercise stress test or a training session. All ACS were
documented by an angiographic control. RESULTS: Overall 5016 stents (41.4%
drug-eluting stents) were implanted in 3132 patients aged 56.5 +/- 12.9 years
(84.7% men) with a median of 1 stent (range 1-8) per patient. Indication of
coronary senting was ACS (86.4%), angina pectoris (8.6%), and silent ischaemia
(5%). Combined antiplatelet treatment was used in 97.2% of the patients. Overall
rate of ACS after coronary stenting was 2.9/1000 patients, corresponding to 1.7
complications out of 10(6) patient-hours of exercise. There were four stent
thromboses related to exercise (1.2/1000 patients, 0.8/10(6) patient-hours of
exercise): two in the early rehabilitation group (days 9 and 11), and two in the
late rehabilitation group (days 77 and 228). CONCLUSIONS: Exercise training seems
safe and there is no justification to delay cardiac rehabilitation after coronary stenting.
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Langue : ANGLAIS