Jaana J Karjalainen1, Antti M Kiviniemi2, Arto J Hautala2, Olli-Pekka Piira3, E Samuli Lepojärvi3, Juha S Perkiömäki3, M Juhani Junttila3, Heikki V Huikuri3, Mikko P Tulppo4. 1. Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland. 2. Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland. 3. Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland. 4. Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland Department of Applied Sciences, London South Bank University, London, U.K. mikko.tulppo@verve.fi.
Abstract
OBJECTIVE:Leisure-time physical activity (LTPA) and exercise training are essential parts of current guidelines for patients with coronary artery disease (CAD). However, the contributions of LTPA and exercise training to cardiovascular (CV) risk in CAD patients with type 2 diabetes (T2D) are not well established. RESEARCH DESIGN AND METHODS: We examined the effects of LTPA (n = 539 and n = 507; with and without T2D, respectively) and 2-year controlled, home-based exercise training (n = 63 plus 64 control subjects with T2D and n = 72 plus 68 control subjects without T2D) on the CV risk profile and composite end point among CAD patients. RESULTS: During the 2-year follow-up, patients with reduced LTPA at baseline had an increased risk of CV events (adjusted hazard ratio 2.3 [95% CI 1.1-5.1; P = 0.033], 2.1 [1.1-4.2; P = 0.027], and 2.0 [1.0-3.9; P = 0.044] for no LTPA, LTPA irregularly, and LTPA two to three times weekly, respectively) compared with those with LTPA more than three times weekly. Among patients who completed the 2-year exercise intervention, exercise training resulted in favorable changes in exercise capacity both in CAD patients with T2D (+0.2 ± 0.8 vs. -0.1 ± 0.8 MET, P = 0.030) and without T2D (+0.3 ± 0.7 vs. -0.1 ± 0.5 MET, P = 0.002) as compared with the control group but did not have any significant effects on major metabolic or autonomic nervous system risk factors in CAD patients with or without T2D. CONCLUSIONS: There is an inverse association between habitual LTPA and short-term CV outcome, but controlled, home-based exercise training has only minor effects on the CV risk profile in CAD patients with T2D.
RCT Entities:
OBJECTIVE: Leisure-time physical activity (LTPA) and exercise training are essential parts of current guidelines for patients with coronary artery disease (CAD). However, the contributions of LTPA and exercise training to cardiovascular (CV) risk in CAD patients with type 2 diabetes (T2D) are not well established. RESEARCH DESIGN AND METHODS: We examined the effects of LTPA (n = 539 and n = 507; with and without T2D, respectively) and 2-year controlled, home-based exercise training (n = 63 plus 64 control subjects with T2D and n = 72 plus 68 control subjects without T2D) on the CV risk profile and composite end point among CAD patients. RESULTS: During the 2-year follow-up, patients with reduced LTPA at baseline had an increased risk of CV events (adjusted hazard ratio 2.3 [95% CI 1.1-5.1; P = 0.033], 2.1 [1.1-4.2; P = 0.027], and 2.0 [1.0-3.9; P = 0.044] for no LTPA, LTPA irregularly, and LTPA two to three times weekly, respectively) compared with those with LTPA more than three times weekly. Among patients who completed the 2-year exercise intervention, exercise training resulted in favorable changes in exercise capacity both in CAD patients with T2D (+0.2 ± 0.8 vs. -0.1 ± 0.8 MET, P = 0.030) and without T2D (+0.3 ± 0.7 vs. -0.1 ± 0.5 MET, P = 0.002) as compared with the control group but did not have any significant effects on major metabolic or autonomic nervous system risk factors in CAD patients with or without T2D. CONCLUSIONS: There is an inverse association between habitual LTPA and short-term CV outcome, but controlled, home-based exercise training has only minor effects on the CV risk profile in CAD patients with T2D.
Authors: Taina Rantanen; Milla Saajanaho; Laura Karavirta; Sini Siltanen; Merja Rantakokko; Anne Viljanen; Timo Rantalainen; Katja Pynnönen; Anu Karvonen; Inna Lisko; Lotta Palmberg; Johanna Eronen; Eeva-Maija Palonen; Timo Hinrichs; Markku Kauppinen; Katja Kokko; Erja Portegijs Journal: BMC Public Health Date: 2018-05-02 Impact factor: 3.295
Authors: Sanna Tiainen; Antti Kiviniemi; Arto Hautala; Heikki Huikuri; Olavi Ukkola; Kari Tokola; Mikko Tulppo; Tommi Vasankari Journal: Antioxidants (Basel) Date: 2018-10-16
Authors: Jean Strelitz; Amy L Ahern; Gráinne H Long; Clare E Boothby; Nicholas J Wareham; Simon J Griffin Journal: Cardiovasc Diabetol Date: 2019-08-01 Impact factor: 9.951