الفهرس 
Metabolic Syndrome (MetS)Only 14 pages are availabe for public view
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Abstract
The present clinical study aimed to evaluate the impact of exercise-based cardiac rehabilitation program plus GDMT on metabolic syndrome in post ACS patients in comparison to guideline directed medical therapy alone. The study conducted on sixth two patients of both genders aged 18-70 years old at least 14 days after ACS and less than weeks duration with evidence of metabolic syndrome.
After approval by the local ethics committee all patients were provided voluntary informed consent. Patients were recruited at Ain Shams University Hospitals (ASUHs) from July 2021 to December 2021. All patients were assessed at baseline and after 12 weeks of follow up for metabolic syndrome parameters.
The study subjects were divided into two groups:
• group A (case group): included 32 patients who completed at least 80% of 12 weeks of cardiac rehabilitation program in addition to guideline directed medical therapy.
• group B (control group): included 30 patients who did not attend the cardiac rehabilitation program, those were completed 12 weeks of guideline directed medical therapy alone.
The study was conducted in Phase II CR Program, at least 14 days after ACS event and took place in the Cardiovascular Prevention and Rehabilitation Unit at ASUHs. Patients were first examined in a medical consultation; their cardiovascular risk factors were stratified with current clinical condition assessed. The prescription of exercise was individualized, after an integration of all the clinical data and physical examination of the patients.
The 32 patients belonging to the case study group (group A) were offered GDMT plus CR program, with supervised exercise training twice weekly in 40-min sessions through 12 weeks. Each session was organized in the following phases: 5–10 min of warming up, 20 min of aerobic treadmill training and 5-10 min of cooling down exercises. During the exercise training sessions patients were under monitor and supervised by one of our team. While 30 patients belonging to the control group (group B) were managed per guideline directed medical therapy and counselled to follow conventional lifestyle modification (smoking cessation, dietary modification and enhance physical activity).
Follow up parameters (at baseline and after 12 weeks): blood pressure (BP) was checked twice for all participants in both arms, waist circumference was measured at the midpoint between the lower border of the rib cage and iliac crest using flexible tape, fasting blood glucose (FBG) and fasting lipid profile were measured by taking sample from the participants, who have fasted 12 hours.
The results revealed that -when compared group A at baseline and after 12 weeks of CR-program there was a significant reduction in WC, FBS and TG levels, while there was a significant rise in HDL-C level. However, there was no statistically significant difference found regarding BP in this group.
Regarding group B there was no statistically significant difference between the baseline MetS parameters and at follow up after 12 weeks of guideline directed medical therapy alone.
Furthermore, the study measured delta changes of MetS parameters of the studied group at the end of the study, in group A there was a significant improvement of MetS parameters namely WC (-5.38 cm), FBS (-14 mg/dl), TG (-20.5 mg/dl) and HDL- C (+3.5 mg/dl), but no delta changes were observed in the same group regarding BP.
While there were no significant delta changes of MetS parameters in group B.