Principal Findings:

There were no between-group differences at baseline regarding average age (57+10 years), gender (80% male), fitness, lipids, history of MI (50%), primary angioplasty for MI (16%), LVEF (50%), smokers (65%), diabetics (18%), number of diseased vessels (about 2/3 > 1 vessel), infarct-related angioplasty (50%), vessel location (65% LAD), lesion type (50% A), stent type and residual diameter stenosis. At 6 months, training was associated with more smoking cessation, reduced systolic BP, total and LDL cholesterol and triglycerides and increased HDL-C. Only trained patients had an improvement in peak V02 (26% compared to baseline), and there was a 26.8% enhanced QOL associated with ET compared to control persisting at least 6 months after training. Angiographic restenosis (average 30%) was unaffected by ET, however residual diameter stenosis was lower in trained patients (29.7% less, p=0.045). Despite angiographic restenosis, thallium uptake improved with ET in 19% of patients and scintigraphy was less capable of detecting restenosis (53% vs. 70%). During an average 33-month follow-up training was associated with a reduction in cardiac event rate (11.9 vs. 32.2%, RR 0.71, p < 0.008), a lower hospital readmission rate (18.6 vs. 46%, RR 0.69, p < 0.001) and a reduced need for further revascularization (10 vs. 27%, RR 0.78 p < 0.03). Reduction in events was not collinear with changes in coronary risk profile and thallium uptake. The only independent predictor of events was exercise training (p=0.008).

Moderate exercise training improves functional capacity and QOL after PTCA/stenting. During follow-up, trained patients had fewer events, less revascularization and a lower hospitalization rate despite no difference in restenosis.