Abstract 15544: Beneficial Effects of Exercise-based Cardiac Rehabilitation on HDL-mediated Cholesterol Efflux Capacity in Patients with Acute Coronary Syndrome

Introduction: Recent studies reported that low HDL-mediated cholesterol efflux capacity rather than low HDL-cholesterol (HDL-C) levels is strongly associated with the increased risk for coronary artery disease. Exercised-based cardiac rehabilitation (CR) can increase HDL-C. However it remains unclear how CR ameliorate HDL function. Methods: We used a cell-based cholesterol efflux system including incubation of 3H-cholesterol labeled macrophages with apolipoprotein B-depleted plasma at the onset of acute coronary syndrome (ACS) and at the end of the 6-month CR program in 50 male and 10 female patients with ACS. Cardio-pulmonary exercise tests were performed at the beginning and the end of CR program. All patients received successful percutaneous coronary intervention on admission. Results: (Table): Fifty-three patients completed CR program. Compared with patients dropped out from CR program, CR participants showed marked amelioration in serum lipid levels, increased efflux capacity, and improved exercise capacity. Spearman’s rank correlation coefficient analysis revealed that % increases of Efflux capacity were significantly associated with % increases in HDL-C (r = 0.647, p < 0.0001), while no association between increases in efflux capacity and increases in cardiopulmonary fitness was observed. Conclusions: CR can markedly increase both HDL-C and HDL cholesterol efflux capacity. These results suggest that CR is very useful therapy for the reverse cholesterol transport, and the secondary prevention. ![][1] [1]: /embed/graphic-1.gif