Regular exercise training compared with percutaneous intervention leads to a reduction of inflammatory markers and cardiovascular events in patients with coronary artery disease

Background Chronic vascular inflammation may trigger ischemic events whereas regular physical exercise training (ET) has shown to be cardioprotective in patients with coronary artery disease (CAD). We investigated the impact of 2 years regular ET versus percutaneous intervention (PCI) on chronic inflammation and cardiovascular events. Methods and results A total of 101 male patients with stable CAD and an indication for revascularization were prospectively randomized to regular ET (n = 51) or PCI with stentimplantation (n = 50). High-sensitive C-reactive protein and interleukin-6, exercise capacity and ischemic endpoints were analyzed at baseline and after 2 years. At 2 years maximal oxygen consumption (Vo2 max) increased by 10% in the ET group (23.3 ± 0.6 to 25.7 ± 1.0 ml O2/kg/min; P = 0.0171 versus baseline) versus 7% in the PCI group (22.3 ± 0.8 to 23.9 ± 1.2 ml O2/kg/min; P = 0.4248). In a subgroup of patients, high-sensitive C-reactive protein levels and interleukin-6 levels were significantly reduced after ET by 41 and 18%, respectively, whereas no relevant changes were observed in the PCI group. Event-free survival rates after 24 months were 78% (ET) versus 62% (PCI) (P = 0.039). Conclusion In patients with stable coronary artery disease, regular physical exercise is associated with a reduction of inflammatory markers and ischemic events.