Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program

Background: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics...

Descripción completa

Detalles Bibliográficos
Autores: Bertolín-Boronat, C, Merenciano-González, H, Marcos-Garcés, V, Martínez-Mas, ML, Alberola, JIC, Pérez, N, López-Bueno, L, Esteban-Argente, MC, Reig, MV, Benito, AA, Rubio, AP, Ríos-Navarro, C, de Dios, E, Gavara, J, Sanchis, J, Bodi, V
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p19379
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/19379
Access Level:acceso abierto
Palabra clave:HDL-cholesterol
cardiac rehabilitation
myocardial infarction
secondary prevention
id ES_48fa2bf32bef7b130a079c0322fbcd4f
oai_identifier_str oai:incliva.fundanetsuite.com:p19379
network_acronym_str ES
network_name_str España
repository_id_str
spelling Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation ProgramBertolín-Boronat, CMerenciano-González, HMarcos-Garcés, VMartínez-Mas, MLAlberola, JICPérez, NLópez-Bueno, LEsteban-Argente, MCReig, MVBenito, AARubio, APRíos-Navarro, Cde Dios, EGavara, JSanchis, JBodi, VHDL-cholesterolcardiac rehabilitationmyocardial infarctionsecondary preventionBackground: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. Methods: We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Results: Our cohort comprised 121 patients (mean age 61.67 +/- 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 +/- 9.18 vs. 39.8 +/- 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11-0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89-0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89-0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07-1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1-1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Conclusions: Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP.IMR PRESS2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/19379Reviews in Cardiovascular MedicineISSN: 15306550ISSNe: 21538174reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p193792026-06-07T16:35:31Z
dc.title.none.fl_str_mv Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
title Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
spellingShingle Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
Bertolín-Boronat, C
HDL-cholesterol
cardiac rehabilitation
myocardial infarction
secondary prevention
title_short Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
title_full Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
title_fullStr Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
title_full_unstemmed Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
title_sort Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program
dc.creator.none.fl_str_mv Bertolín-Boronat, C
Merenciano-González, H
Marcos-Garcés, V
Martínez-Mas, ML
Alberola, JIC
Pérez, N
López-Bueno, L
Esteban-Argente, MC
Reig, MV
Benito, AA
Rubio, AP
Ríos-Navarro, C
de Dios, E
Gavara, J
Sanchis, J
Bodi, V
author Bertolín-Boronat, C
author_facet Bertolín-Boronat, C
Merenciano-González, H
Marcos-Garcés, V
Martínez-Mas, ML
Alberola, JIC
Pérez, N
López-Bueno, L
Esteban-Argente, MC
Reig, MV
Benito, AA
Rubio, AP
Ríos-Navarro, C
de Dios, E
Gavara, J
Sanchis, J
Bodi, V
author_role author
author2 Merenciano-González, H
Marcos-Garcés, V
Martínez-Mas, ML
Alberola, JIC
Pérez, N
López-Bueno, L
Esteban-Argente, MC
Reig, MV
Benito, AA
Rubio, AP
Ríos-Navarro, C
de Dios, E
Gavara, J
Sanchis, J
Bodi, V
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv HDL-cholesterol
cardiac rehabilitation
myocardial infarction
secondary prevention
topic HDL-cholesterol
cardiac rehabilitation
myocardial infarction
secondary prevention
description Background: Exercise-based cardiac rehabilitation programs (CRP) are recommended for patients following acute coronary syndrome to potentially improve high-density lipoprotein cholesterol (HDL-C) levels and prognosis. However, not all patients reach target HDL-C levels. Here we analyze the dynamics and predictors of HDL-C increase during CRP in patients following ST-segment elevation myocardial infarction or occlusion myocardial infarction. Methods: We conducted a prospective study of myocardial infarction patients who completed exercise-based Phase 2 CRP. Data was collected on clinical variables, cardiovascular risk factors, treatment goals, pharmacological therapy, and health outcomes through questionnaires at the beginning and at the end of Phase 2 CRP. Lipid profile analysis was performed before discharge, 4 to 6 weeks after discharge, and at the end of Phase 2 CRP. Changes in lipid profiles were evaluated, and predictors of failure to increase HDL-C levels were identified by binary logistic regression analysis. Results: Our cohort comprised 121 patients (mean age 61.67 +/- 10.97 years, 86.8% male, and 47.9% smokers before admission). A significant decrease in total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were noted, along with an increase in HDL-C (43.87 +/- 9.18 vs. 39.8 +/- 10.03 mg/dL, p < 0.001). Patients achieving normal HDL-C levels (>40 mg/dL in men and >50 mg/dL in women) significantly increased from 34.7% at admission to 52.9% the end of Phase 2. Multivariable analysis revealed smoking history (hazard ratio [HR] = 0.35, 95% confidence interval [CI], 0.11-0.96, p = 0.04), increased reduction in total cholesterol (HR = 0.94, 95% CI, 0.89-0.98, p = 0.004), and increased reduction in LDL-C (HR = 0.94, 95% CI, 0.89-0.99, p = 0.01) were inversely associated with failure to increase HDL-C levels. Conversely, higher HDL-C before CRP (HR = 1.15, 95% CI, 1.07-1.23, p < 0.001) and increased lipoprotein (a) (HR = 1.01, 95% CI, 1-1.02, p = 0.04) predicted failure to increase HDL-C levels. No significant correlations were found with Mediterranean diet adherence, weekly physical activity, training modalities, or physical fitness parameters. Conclusions: Participation in an exercise-based Phase 2 CRP led to mild but significant increases in HDL-C. Smoking history and patients experiencing substantial reductions in total cholesterol and LDL-C were more likely to experience HDL-C increases, unlike those with higher HDL-C and lipoprotein (a) levels before CRP.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/19379
url https://incliva.portalinvestigacion.com/publicaciones/19379
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv IMR PRESS
publisher.none.fl_str_mv IMR PRESS
dc.source.none.fl_str_mv Reviews in Cardiovascular Medicine
ISSN: 15306550
ISSNe: 21538174
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869407393374273536
score 15,81155

Similares en LA Referencia