Effect of a Cardiac Rehabilitation (CR) Programme on Molecular Mechanisms

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

28 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-02-23

Study Completion Date

2020-07-01

Brief Summary

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This study will evaluate the effect of a cardiac rehabilitation (CR) programme on blood protein molecules that may improve the function of arteries in coronary artery disease (CAD) patients who have suffered a heart attack. CAD patients who have either agreed or disagreed to take part in a CR programme will be recruited. This will allow a comparison of the study measurements between a group of patients who complete a CR programme and a group of patients who do not.

The other objective of this study is to perform interviews with the study participants and their significant others (i.e. spouse, family member, or a close friend) to listen to the reasons why patients agreed or disagreed to take part in a CR programme.

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Detailed Description

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An exercise-based cardiac rehabilitation (CR) programme is an established method of secondary prevention of coronary artery disease (CAD). Moreover, there is a body of evidence that supports the ability of this intervention to reduce hospital readmissions and cardiovascular mortality. However, despite the proven benefit, CR programmes are underutilised worldwide. Moreover, the molecular mechanisms responsible for orchestrating the beneficial physiological adaptations induced by a CR programme are poorly understood.

Therefore, this study will evaluate the effect of a CR programme on novel molecular mechanisms and endothelial function in post-myocardial infarction CAD patients. Additionally, semi-structured interviews will be conducted with study participants and their significant others (i.e. spouse, family member, or a close friend) to explore the reasons why patients may agree or disagree to take part in a CR programme. Altogether, this study will provide physiological and detailed qualitative information that may help to provoke an increased participation in CR programmes.

Conditions

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Coronary Artery Disease Coronary Arteriosclerosis Myocardial Infarction Myocardial Ischemia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Phase-III Cardiac Rehabilitation

Eight weeks of supervised exercise sessions (one session per week).

Exercise-based cardiac rehabilitation

Intervention Type BEHAVIORAL

Moderate intensity aerobic exercise, lifestyle advice, and psychological support.

Phase-III and Phase IV Cardiac Rehabilitation

Twenty weeks of supervised exercise sessions (one session per week for first eight weeks \[phase-III\], session frequency determined by participant for remaining twelve weeks \[phase-IV\].

Exercise-based cardiac rehabilitation

Intervention Type BEHAVIORAL

Moderate intensity aerobic exercise, lifestyle advice, and psychological support.

No Cardiac Rehabilitation

Participants who declined to take part in a cardiac rehabilitation programme.

No interventions assigned to this group

Interventions

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Exercise-based cardiac rehabilitation

Moderate intensity aerobic exercise, lifestyle advice, and psychological support.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Formally diagnosed coronary artery disease with evidence of ST- elevated or non-ST elevated myocardial infarction, as determined by evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia, and the detection of a rise and / or fall in cardiac biomarker values (preferably cardiac troponin), with at least one value above the 99th percentile upper reference limit, along with at least one of the following:

Symptoms of ischaemia, such as: extreme fatigue, breathlessness, chest pain, and heart palpitations.

New or presumed new significant ST-segment-T wave changes or new left bundle branch block.

Development of pathological Q waves on the electrocardiogram.

Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.

Identification of an intracoronary thrombus by angiography

* Over 18 years of age.
* Male or Female.
* Provision of informed consent.
* Ability to speak and write in English.
* Patients who have agreed to participate in a phase-III cardiac rehabilitation programme must be willing to attend the supervised group exercise sessions.
* No hospital readmissions with unstable symptoms (e.g. chest pain, shortness of breath, discomfort, or nausea) during the previous 4-weeks.
* Willing to comply with trial requirements.

* Patient has either declined or agreed to participate in a phase-III or phase-IV cardiac rehabilitation programme.
* Sufficient English language skills to understand and participate in an interview discussion.
* Over 18 years of age.
* Identified significant other provides informed consent to participate in the study.

* Nominated by the patient and willing to participate.
* Impacted or involved throughout the period of the patient's cardiovascular complication and recovery (e.g. familial relation, co-habitant, or close-relationship).
* Sufficient English language skills to understand and participate in an interview discussion.
* Over 18 years of age.
* Patient provides informed consent to participate in the study.

Exclusion Criteria

* Unstable angina pectoris (angina at rest or persistent angina regardless of pharmacological treatment e.g. glyceryl trinitrate).
* Uncontrolled cardiac arrhythmia.
* Survivor of cardiac arrest or cardiogenic shock.
* Any form of anaemia (haemoglobin \< 90 grams / litre).
* Hepatic failure.
* Uncontrolled hypertension (resting systolic measurement \> 180 mm Hg and / or diastolic measurement \> 100 mm Hg).
* History of Raynaud's phenomenon.
* Congenital or acquired physical abnormalities of both arms.
* Consumption of vitamins, herbal, testosterone, estrogen/ progesterone, or antioxidant supplementation.
* Pregnant.
* History of or diagnosed with any form of cancer.
* Current participation in a different research study.

\- Identified significant other refuses to participate or provide informed consent.

\- Patient refuses to participate or provide informed consent.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No