The Effect of Resistance Training on Proprotein Subtilisin Convertase Kexin 9 Level After Coronary Bypass Surgery

Study Overview
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Brief Summary
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This research add resistance training to patients who undergo cardiac rehabilitation program after coronary bypass surgery, comparing the level of PCSK9 level on that group to another group who receives conventional rehabilitation program (only aerobic exercise)

Detailed Description
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The PCSK9 level measured before and after cardiac rehabilitation program (around 3-4 weeks), and compared between two groups. ELISA method will be used to measure plasma PCSK9 level. Resistance training will be given by professional trainer in gymnasium of National Cardiovascular Center Harapan Kita supervised by cardiologists, following rules from American College of Sports Medicine guideline regarding to exercise after cardiac event.

Official Title
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The Effect of Resistance Training on Proprotein Subtilisin Convertase Kexin 9 (PCSK-9) Level in Patients After Coronary Bypass Surgery

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Behavioral: resistance training
* Behavioral: aerobic training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: post elective coronary artery bypass surgery > 18 years old sign informed consent Exclusion Criteria: contraindications of resistance training (unstable angina, uncontrolled blood pressure (systolic > 160 mmHg diastolic > 100 mmHg), acute heart failure, pulmonary diseases, arrhythmia malignant) musculoskeletal pain, visual analog scale >3 post congenital heart disease surgery post elective coronary artery bypass surgery with malfunction valves (operated or not)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Control group<br>Patients after coronary bypass surgery who undergo conventional cardiac rehabilitation program (aerobic training only) | Behavioral: aerobic training<br>* aerobic exercise consists of warming up session, treadmill exercise (around 20-30 minutes), and wrap-up session (for all session about 1 hour)<br>|
| Experimental: Intervention group<br>Patients after coronary bypass surgery who undergo conventional cardiac rehabilitation program plus resistance training (aerobic and resistance training as well) | Behavioral: resistance training<br>* resistance training consists of lower and upper extremities exercises. We focus on biceps and hamstring to be trained. One session was held for around 30 minutes.<br>Behavioral: aerobic training<br>* aerobic exercise consists of warming up session, treadmill exercise (around 20-30 minutes), and wrap-up session (for all session about 1 hour)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PCSK-9 Level | this outcome measurement will be achieved by taking patient's blood sample after cardiac rehabilitation program. The method that we use to check PCSK-9 level is ELISA method | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Low Density Lipoprotein | this outcome measurement will be achieved by taking patient's blood sample after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Body Mass Index | Body Mass Index is calculated by calculating the measured body weight divided by the height square in measure. We take BMI data after cardiac rehabilitation program in every participant. | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| High-Density Lipoprotein | this outcome measurement will be achieved by taking patient's blood sample after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Total Cholesterol | this outcome measurement will be achieved by taking patient's blood sample after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Triglyceride | This outcome measurement will be achieved by taking the patient's blood sample after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Fasting Blood Glucose | Blood glucose concentration was taken after 10-12-hour fasting. This outcome measurement will be achieved by taking the patient's blood sample after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Systolic Blood Pressure | this outcome measurement will be achieved by taking the patient's blood pressure after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 
| Diastolic Blood Pressure | this outcome measurement will be achieved by taking the patient's blood pressure after cardiac rehabilitation program | 3-4 weeks (after completion of 12 sessions of cardiac rehabilitation program) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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resistance training, PCSK9, coronary artery bypass grafting