Yu HK; Mackay Memorial Hospital, Taipei, Taiwan.
Chen CY; Chen YC; Cheng CH; Chen CY; Hu GC

Journal of Cardiopulmonary Rehabilitation & Prevention. 44(5):311-316,
2024 Sep 01.

PURPOSE: Following acute myocardial infarction (AMI), patients with
diabetes mellitus (DM) have a poorer prognosis than those without DM. This
study aimed to investigate the benefit of cardiac rehabilitation on
cardiorespiratory fitness in patients with AMI, examining whether this
effect varied depending on DM and glycated hemoglobin (HbA1c) levels.
METHODS: Data were collected from the medical records of 324 patients
diagnosed with AMI who were subsequently referred to participate in a
supervised exercise-based cardiac rehabilitation program.
Cardiorespiratory fitness was assessed using cardiopulmonary exercise
testing before and at 3 and 6 mo after the start of cardiac
rehabilitation. Linear mixed models were used to evaluate changes in
cardiorespiratory fitness between patients with and without DM during the
follow-up period.
RESULTS: In total, 106 patients (33%) had DM. Both patients with and
without DM showed a significant improvement in cardiorespiratory fitness
from baseline to the 6-mo follow-up. However, the improvement was
significantly lower in patients with DM than in those without DM (1.9 +/-
1.5 vs. 3.7 +/- 3.2 mL/kg/min, P < .001). Among patients with DM, those
with HbA1c levels < 7% showed a greater improvement in cardiorespiratory
fitness than those with HbA1c >= 7% (2.7 +/- 1.5 vs. 1.1 +/- 1.8
mL/kg/min, P < .001) during the follow-up period.
CONCLUSIONS: Improvements in cardiorespiratory fitness following cardiac
rehabilitation were significantly lower in patients with AMI and DM. The
response to cardiac rehabilitation in patients is influenced by HbA1c
levels. These findings suggest potential implications for individualizing
cardiac rehabilitation programming and ensuring optimal glycemic control
in patients with AMI and DM.