Evaluation of Maintained PhysicAl CaPacity 1-yr After Coronary Patient Cardiac Rehabilitation (EMAP)

The medium-term results of exercise rehabilitation are poorly known in France. This multicenter study showed maintenance or improvement of exercise capacity at 1 yr after cardiac rehabilitation in more than two-thirds of cases, without specific support, and could serve as a reference for future follow-up studies. Purpose: Data are scarce concerning the sustainable effects of cardiac rehabilitation (CR), on cardiorespiratory fitness (CRF) of patients with coronary artery disease (CAD). This study, carried out using data from a French multicenter study, aimed to clarify the evolution of the CRF of patients with CAD 1 yr after the end of a CR stay. Methods: Patients were included after an acute coronary syndrome (77%) and/or coronary revascularization, occurring <3 mo beforehand. All underwent a CR program with CRF evaluation by exercise testing (ET) on a cycle ergometer at the beginning of CR (ET1), at its end (ET2), and 1 yr later (ET3)—all ETs were performed with medication. Results: Two hundred fifty-nine patients were included (age 60 ± 10 yr, 89% male) in 16 French CR centers. Left ventricular ejection fraction was 55.3 ± 9%. Revascularization was complete (82%). Maximal workloads were 110 ± 37 (ET1), 139 ± 43 (ET2), and 144 ± 46 W (ET3) (P < .001). The estimated metabolic equivalents of the task (METs) were respectively 5.3 ± 1.4, 6.4 ± 1.6 (P < .001), and 6.6 ± 1.7 (P < .002). One year later, 163 patients (63%) improved or maintained their CRF (ET3 ≥ ET2), 73 (28%) decreased (ET1 < ET3 < ET2), and 23 (9%) lost the benefit of CR (ET3 ≤ ET1). Conclusion: Among completers who agreed to enroll in this study, most patients with CAD seem to maintain their CRF 1 yr after CR.