Objective: T he aim of this prospective study was to evaluate the role of cardiac rehabilitation treatment in improving cardiovascular outcomes by assessing Fra-mingham risk score and H-FABP values in coronary artery bypass grafting (CABG) patients, at the admis-sion, in less than one week after cardiovascular surgery and in 6 months of follow-up after the engagement in the cardiac recovery program.
Methods: During 01.05.2015 – 01.09.2017, CABG was performed in 120 patients, aged 41-85 years old. The H-FABP values were determined immediately after CABG performed in patients that suffered a myocardi-al infarction (Phase I), and during the Phase II and III after the enrollment in the cardiac rehabilitation pro-gram. Framingham Risk Score was evaluated in pre-CABG and in Phase III of CR.
Results: The overall mean age was 65.93 ± 9.83 years old, with a similar value of 65.47 ± 10.18 for men, and a slight difference for the 29 women under study (67.35 8.67 years old). In the first week after CABG, the 10-year cardiac risk was above 14.8% and 18.1% for half of the women and men groups, while 6 months later, half of the study group (men and women) had 10-years cardiac risk below 10%. By comparing the Phase I and Phase III results, the median Framingham score decre-ase by 8.24 points (p<0.05) in more than 50% of pati-ents. The H-FABP mean values were 68.40 ±46.04 ng/ ml in the first phase of CR, and 4.82 ±1.24 ng/ml in the latest. The difference registered between the plasma H-FABP value in the first 24 hours after cardiac surgery and the value in 6 months after the onset of cardiac rehabilitation program was important and statistically significant (p<0.05).
Conclusions: H-FABP could be a marker to indicate the quality of clinical and morphological evolution in post-myocardial infarction. The reduction of H-FABP was correlated with the change in Framingham score items, and it was influenced by the change of life be-havior, by being compliant to continuously performing the cardiovascular recovery program. Decreasing Fra-mingham score with very great values shows the im-portance of no disregarding the management of any item of the score during the AMI recovery phases.