Effect of cardiac rehabilitation program on high-sensitivity C-reactive protein (HSCRP) levels in patients with ischemic heart disease

Abstract

C ardiovascular diseases remain the biggest cause of deaths worldwide. Although over the last two decades cardiovascular mortality rates have declined in many high-income countries, they have increased at an astonishingly fast rate in low- and middle-income countries. Due to the high incidence of cardiovascular diseases, their treatment methods and techniques were improved in recent decades. In the mid-1990s, immunoassays for C-reactive protein (CRP), with greater sensitivity than those previously in routine use, revealed that increased CRP values, even within the range previously considered normal, strongly predict future coronary events. These findings triggered widespread interest, especially, remarkably, in the US, where the clinical use of CRP measurement had been largely ignored for about 30 years. CRP production is part of the nonspecific acute-phase response to most forms of inflammation, infection, and tissue damage and was therefore considered not to provide clinically useful information. This prospective study was carried out at rehabilitation unit in the department of cardiology Ain Shams University between October 2014 and February 2015. The aim of our study was to assess the effects of cardiac rehabilitation program on high-sensitivity C-reactive protein (HSCRP) levels in patients with ischemic heart disease. We analyzed plasma levels of HSCRP in(80) patients with coronary artery disease CHD (40) consecutive patients before and after cardiac rehabilitation and exercise training programs and 40 “control” patients who did not attend cardiac rehabilitation program. In our rehabilitation cohort, 33 (82.5%) patients were male. Of the control group 28 (70%) patients were male. There was no significant difference between both groups (p=0.189), and the mean age of our cohort was 50.65 ± 5.35 years. Baseline assessment (including HSCRP) was obtained in rehabilitation patients and control patients following the cardiac event. The mean BMI of the cohort was 29.58 ±4.54 kg/m2. The median concentration of HSCRP at entry was 21.7 mg/l (range 16.17 to 34.41 mg/l); mean concentration was 27.25±18.46 mg/l at baseline.