Long-term cardiac rehabilitation program favorably influences fibrinolysis and lipid concentrations in acute myocardial infarction

Background and Objective
The control of wellknown atherosclerotic risk factors represents the optimal strategy in the prevention of acute coronary syndromes. It was the aim of this work to analyze the effects of a long-term cardiac rehabilitation program on the changes of fibrinolysis parameters and plasma lipid profile in coronary patients.

Design and Methods
The study was carried out in 30 (M/F:22/8, mean age 47 years) survivors of a

first acute myocardial infarction (AMI) and in 30 healthy controls who underwent a cardiac rehabilitation program (9 months duration). Samples were taken before, at 3 and 9 months after the beginning of the program to measure: tissue-type plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI-1) activity and antigen. A lipid profile including cholesterol (both HDL and LDL) and lipoprotein (a) was also assessed. The Wilcoxon and Mann-Whitney tests were used for statistical comparisons.

Results
There was a marked decrease of functional PAI-1 after 3 and 9 months as compared with baseline in AMI patients (p<0.01). Results showed a significant increase of HDL-cholesterol (p<0.01) and decrease of lipoprotein(a) levels after the exercise program (p <0.01).

Interpretation and Conclusions
The cardiac rehabilitation program improved fibrinolysis, by reducing the functional levels of PAI-1, and ameliorated the lipid profile by decreasing lipoprotein(a) and increasing HDL-cholesterol in patients with AMI. A longterm cardiac rehabilitation has positive effects on some risk factors for coronary disease.

CITA DEL ARTÍCULO Haematologica. 1998 Jun;83(6):519-24