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Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention?

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Abstract

Coronary artery disease (CAD) is a leading cause of death worldwide, and percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty) are commonly used to diagnose and/or treat the obstructed coronaries. Exercise-based rehabilitation is recommended for all CAD patients; however, most guidelines do not specify when exercise training should commence following PTCA and/or PCI. Catheterization can result in arterial dysfunction and acute injury, and given the fact that exercise, particularly at higher intensities, is associated with elevated inflammatory and oxidative stress, endothelial dysfunction and a pro-thrombotic milieu, performing exercise post-PTCA/PCI may transiently elevate the risk of cardiac events. This review aims to summarize extant literature relating to the impacts of coronary interventions on arterial function, including the time-course of recovery and the potential deleterious and/or beneficial impacts of acute versus long-term exercise. The current literature suggests that arterial dysfunction induced by catheterization recovers 4–12 weeks following catheterization. This review proposes that a period of relative arterial vulnerability may exist and exercise during this period may contribute to elevated event susceptibility. We therefore suggest that CAD patients start an exercise training programme between 2 and 4 weeks post-PCI, recognizing that the literature suggest there is a ‘grey area’ for functional recovery between 2 and 12 weeks post-catheterization. The timing of exercise onset should take into consideration the individual characteristics of patients (age, severity of disease, comorbidities) and the intensity, frequency and duration of the exercise prescription.

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Authors and Affiliations

  1. Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK

    Andrea Tryfonos & Ellen A. Dawson

  2. School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, 6009, Australia

    Daniel J. Green

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Prof. Green is funded by the National Health and Medical Research Council of Australia Principal Research Fellowship (1080914).

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Tryfonos, A., Green, D.J. & Dawson, E.A. Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention?. Sports Med 49, 397–416 (2019). https://doi.org/10.1007/s40279-019-01055-3

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