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...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2025 |
| Country: | España |
| Institution: | INCLIVA |
| Repository: | r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| OAI Identifier: | oai:incliva.fundanetsuite.com:p19379 |
| Online Access: | https://incliva.portalinvestigacion.com/publicaciones/19379 |
| Access Level: | Open access |
| Keyword: | HDL-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| _version_ | 1878732746351706112 |
|---|---|
| author | Bertolín-Boronat, C |
| 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 |
| author_browse | Alberola, JIC Benito, AA Bertolín-Boronat, C Bodi, V Esteban-Argente, MC Gavara, J López-Bueno, L Marcos-Garcés, V Martínez-Mas, ML Merenciano-González, H Pérez, N Reig, MV Rubio, AP Ríos-Navarro, C Sanchis, J de Dios, E |
| 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 |
| collection | r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_48fa2bf32bef7b130a079c0322fbcd4f |
| institution | INCLIVA |
| instname_str | INCLIVA |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:incliva.fundanetsuite.com:p19379 |
| publishDate | 2025 |
| publishDateSort | 2025 |
| publisher | IMR PRESS |
| publisherStr | IMR PRESS |
| reponame_str | r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| spelling | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program 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 HDL-cholesterol cardiac rehabilitation myocardial infarction secondary prevention 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. IMR PRESS https://incliva.portalinvestigacion.com/publicaciones/19379 |
| spellingShingle | Dynamics of HDL-Cholesterol Following a Post-Myocardial Infarction Cardiac Rehabilitation Program Bertolín-Boronat, C HDL-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| status_str | publishedVersion |
| title | 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_short | 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 |
| topic | HDL-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| topic_facet | HDL-cholesterol cardiac rehabilitation myocardial infarction secondary prevention |
| url | https://incliva.portalinvestigacion.com/publicaciones/19379 |