Cardiac Rehabilitation and Change of Plasma Cardiac Biomarkers in Patients with Coronary Artery Disease: A Prospective Single-Center Study

Background: Cardiac rehabilitation (CR) has been proven to have benefits including reduced mortality, reduced cardiovascular events, and improved functional capacity. This study aimed to investigate the difference in the response of multiple biomarkers in patients with coronary artery disease (CAD) following CR therapy. Methods: Biomarkers, including N-terminal-pro B-type natriuretic peptide (NTproBNP), midregional atrial natriuretic peptide (MRproANP), MR-pro adrenomedullin (MRproADM), C-reactive protein (CRP), and soluble suppressor of tumorigenicity (sST2) were sampled, and a cardiopulmonary exercise test was conducted at enrolment and after completion of the study. Physician-supervised exercise protocol consisted of a 6-month program with three sessions of physical training per week. Results: This study included 23 patients (19 men, median age: 65 years). After the 6-month exercise protocol, there was a significant decrease in CRP levels (0.4 vs. 0.3 mg/L, p = 0.006) and NTproBNP levels (86.5 vs. 85.7 pg/mL, p = 0.017) before and after CR program. In contrast, there was a significant increase in MRproADM, MRproANP, and neopterin levels before and after CR (122.4 vs. 236.7 pg/mL, p = 0.005; 129.4 vs. 198.0 pg/mL, p <0.001 and 6.6 vs. 10.2 nmol/L, p <0.001, respectively). Conculsions: Our findings suggest that a 6-month program of CR has benefits on cardiac function and is considered an important nonpharmacological strategy in patients with mild CAD.