Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
Background: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we an...
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IMR Press
2025-01-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25399 |
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| author | Carlos Bertolín-Boronat Héctor Merenciano-González Víctor Marcos-Garcés María Luz Martínez-Mas Josefa Inés Climent Alberola Nerea Pérez Laura López-Bueno María Concepción Esteban-Argente María Valls Reig Ana Arizón Benito Alfonso Payá Rubio César Ríos-Navarro Elena de Dios Jose Gavara Juan Sanchis Vicente Bodi |
| author_facet | Carlos Bertolín-Boronat Héctor Merenciano-González Víctor Marcos-Garcés María Luz Martínez-Mas Josefa Inés Climent Alberola Nerea Pérez Laura López-Bueno María Concepción Esteban-Argente María Valls Reig Ana Arizón Benito Alfonso Payá Rubio César Ríos-Navarro Elena de Dios Jose Gavara Juan Sanchis Vicente Bodi |
| author_sort | Carlos Bertolín-Boronat |
| collection | DOAJ |
| description | Background: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. Methods: We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Results: Our cohort comprised 121 patients (mean age 61.67 ± 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 ± 9.18 vs. 39.8 ± 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11–0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89–0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89–0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07–1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1–1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Conclusions: Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP. |
| format | Article |
| id | doaj-art-a4d28068186a4a778fadf6a174f2bdb0 |
| institution | Kabale University |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-a4d28068186a4a778fadf6a174f2bdb02025-01-25T10:41:20ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-01-012612539910.31083/RCM25399S1530-6550(24)01612-0Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation ProgramCarlos Bertolín-Boronat0Héctor Merenciano-González1Víctor Marcos-Garcés2María Luz Martínez-Mas3Josefa Inés Climent Alberola4Nerea Pérez5Laura López-Bueno6María Concepción Esteban-Argente7María Valls Reig8Ana Arizón Benito9Alfonso Payá Rubio10César Ríos-Navarro11Elena de Dios12Jose Gavara13Juan Sanchis14Vicente Bodi15Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainINCLIVA Health Research Institute, 46010 Valencia, SpainDepartment of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainHospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Rehabilitation, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainINCLIVA Health Research Institute, 46010 Valencia, SpainNetwork Biomedical Research Center for Cardiovascular Diseases (CIBER-CV), 28029 Madrid, SpainCentre for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainDepartment of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, SpainBackground: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. Methods: We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Results: Our cohort comprised 121 patients (mean age 61.67 ± 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 ± 9.18 vs. 39.8 ± 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11–0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89–0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89–0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07–1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1–1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Conclusions: Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP.https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25399hdl-cholesterolcardiac rehabilitationmyocardial infarctionsecondary prevention |
| spellingShingle | Carlos Bertolín-Boronat Héctor Merenciano-González Víctor Marcos-Garcés María Luz Martínez-Mas Josefa Inés Climent Alberola Nerea Pérez Laura López-Bueno María Concepción Esteban-Argente María Valls Reig Ana Arizón Benito Alfonso Payá Rubio César Ríos-Navarro Elena de Dios Jose Gavara Juan Sanchis Vicente Bodi Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program Reviews in Cardiovascular Medicine hdl-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| title | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program |
| title_full | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program |
| title_fullStr | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program |
| title_full_unstemmed | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program |
| title_short | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program |
| title_sort | dynamics of hdl cholesterol following a post myocardial infarction cardiac rehabilitation program |
| topic | hdl-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| url | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25399 |
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