Resistance training decreases PCSK9 levels in patients undergoing phase II cardiac rehabilitation after coronary artery bypass grafting: A randomized study

Abstract

Abstract Background: Resistance training is recommended for post coronary by-pass artery graft (CABG) patients in addition to aerobic training as part of secondary prevention. However, there is a lack of studies that investigate the impact of resistance training on proprotein convertase subtilisin kexin 9 (PCSK9). Aim: This study aims to assess the impact of intensive resistance training on PCSK9 level in post-CABG patients undergoing phase II cardiac rehabilitation. Methods: In this randomized, prospective, open label trial, 87 post­CABG patients were assigned to moderate to high intensity resistance training and aerobic training (n=44) and aerobic training only (n=43) for 3­4 weeks. The primary endpoint was change of PCSK9 levels after cardiac rehabilitation program. Secondary endpoints include change of six-minute walk test (6-MWT) result, aerobic capacity, WHO­5 well­being index, fasting blood glucose and lipid profile. Intention-to-treat analysis was performed in both groups. Results: After completion of phase II cardiac rehabilitation, mean PCSK9 levels in intervention group decreased significantly compared to control group (β=­55 ng/ml, 95%CI ­6.7 to ­103.3, p=0.026). This reduction was followed by significant improvement of 6-MWT result (β=28.2 m, 95%CI 2.4-53.9, p=0.033), aerobic capacity (β=0.9 Mets, 95%CI 0.1-1.7, p=0.021), and WHO­5 well­being index (β=8.1, 95%CI 2.0-14.4, p=0.011) in patients who performed resistance training in addition to aerobic training. There are no significant changes in fasting blood glucose, cholesterol, LDL­C, HDL-C, and triglyceride. Conclusion: The addition of resistance training to aerobic training components in phase II cardiac rehabilitation significantly reduces PCSK­9 levels and increases patient’s functional capacity and quality of life. (NCT02674659)