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Differences in exercise test results in diabetic and non-diabetic post-myocardial infarction patients after cardiac rehabilitation

Background and Aims:To define the differences in exercise test results in regard to the percentage of the achieved workload and METs, between diabetic patients type II and patients without diabetes mellitus, who were included in a program of cardiac rehabilitation in our Institute up to one year after a heart attack. Materials and Methods: 219 men without diabetes mellitus and 44 diabetic men type II were included in our study. They all underwent a cardiac rehabilitation program from 1999 through 2002, suffered from the first heart attack within a year prior to cardiac rehabilitation, and had no coronary intervention. The exercise test measures of cholesterol and triglycerides were done to all patients before leaving the program of cardiac rehabilitation. An average of more than 50% of the patients were on statine therapy. The percentage of the achieved workload, METS, and ischemic ECG response were examined in exercise test. Unregulated arterial hypertension was not the reason of stopping exercise test in any of the patients. Results: The average age of the patients without diabetes was 55.69+_9.45 (range 29-83 years), and diabetic patients type II 57.18+_7.64 (range 42-73 years)(p=NS). The average cholesterol level in patients without diabetes was 5.1+_1.08 mmol/l (range 2.03-8.46), and in diabetic patients type II 5.16+_1.21 mmol/l(range 2.33-8.30)(p=NS), and the average triglyceride level in patients without diabetes was 2.18+_1.60 mmol/l (range 0.41-14.5), and 2.89+_2.53 mmol/l(range 0.89-14.26)in the diabetic group (p=0.018). The percentage of the achieved workload in patients without diabetes mellitus was 79.67+_14.89% (range 46-122), and in diabetic patients type II 70.92+_14.81 (range 31-103)(p=0.00045). An ischemic ECG response was found in 25 (13%) of patients without diabetes mellitus and in 3 (7%) of diabetic patients (p=NS). 2 patients had LBBB in ECG. Conclusion: Patients in both groups were of the same age and there was no difference in cholesterol levels. Triglyceride levels are significantly higher in the group of diabetic patients. Patients without diabetes mellitus had a significantly higher percentage of achieved workload and more METs in the exercise test. More patients with and ischemic ECG response were found in the group without diabetes mellitus but this difference was not statistically significant. Metabolic disorder in diabetic patients significantly reduces their physical capacity, which was not related to coronary flow.

diabetes; myocardial infarction; exercise test; cardiac rehabilitation

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