Heart-type Fatty Acid-Binding Protein (H-FABP), compared with classical biomarkers, proved to have high sensitivity for myocardial damage size in patients undergoing cardiac surgery. High H-FABP levels are strongly associated in case of death, post-operatively acute kidney injury and atrial fibrillation. Cardiac rehabilitation is an instrument of medical management in cardiovascular diseases; beyond prevention, it can improve heart and muscle functioning in patients that were undergoing CABG, and cardiac and vascular adaptation. Over a 2-year period, 110 subjects were randomized and comprehensively evaluated. The mean age of the patients under study was 65.70 ± 9.91 years old. For the H-FABP, the mean value in the Phase I was 67.40 ± 9.81 ng/mL, while the mean value in Phase III was 4.80 ± 2.30 ng/mL. The difference registered between the plasma H-FABP value in the first 24 h after cardiac surgery and the value in 6 months after the onset of cardiac rehabilitation program was important and statistically significant, as p < 0.05. Fibrinogen showed significant phase-to-phase reductions of plasmatic values. Lipid profile values showed a statistically significant decrease. The renal filtration function evaluated by plasma creatinine showed statistically significant improvement and, in terms of absolute values, creatinine level was reduced in a range between 0.2-0.4 mg/dL. Also, it was recorded a significantly lower level of blood urea. The reduction of plasma H-FABP values were registered between the first phase (the first 24 h) after cardiac surgery and the third phase of the cardiac rehabilitation program. H-FABP protein had a higher sensitivity and specificity when compared to other enzymes of myocardial cytolysis.

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Heart-type fatty acid-binding protein (H-FABP) is a non-invasive bio-marker, with high sensitivity and specificity, being capable to point out the myocardial injury and to predict major adverse cardiovascular events (MACE). Cardiac rehabilitation program, through a complex and sustained post-interventional management plays an important role in reducing the plasma levels of H-FABP. In the study, which included 120 post-coronary artery bypass (CABG) patients, we analyzed the link between low levels of general post-surgical health status and the presence of cardiovascular risk factors, common biochemical markers, and especially the role played by diabetic status in lowering the plasma H-FABP levels. From the group, 65 patients had been diagnosed with type 2 Diabetes Mellitus (T2DM). The H-FABP values decreased both in diabetics and in non-diabetics between the two phases of CR, 6 months away from CABG. More than half of the patients had important reduction of H-FABP, at 6 months after the onset of CR program. Half of the group registered a smaller reduction of H-FABP, but more noticeable in diabetics. Ischemic lesion during open heart surgery is linked to high levels of H-FABP and with an occurence risk of postoperative atrial fibrillation, that can be also triggered and sustained by multiple endocrine conditions related to aging. Thus, metabolic control should always remain a target of the complex management in cardiac rehabilitation.

Coronary artery disease (CAD) is one of the major predictors of future cardiovascular events (CVEs). In addition, biomarkers such as high-sensitivity C-Reactive Protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) correlate well with a future CVE. The Framingham Risk Score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. Cardiac rehabilitation is an instrument of medical management in cardiovascular diseases; beyond prevention, it can improve heart and muscle functioning in patients that were undergoing CABG, and cardiac and vascular adaptation. Over a 2-year period, 120 subjects were randomized and comprehensively evaluated. The mean age of the patients under study was 65.70 � 9.91 years old. For the Framingham cardiovascular risk score, the mean value in the Phase I was 16.5, while the mean value in Phase III was 10.6. The difference registered after cardiac surgery and the value in 6 months after the onset of cardiac rehabilitation program was important and statistically significant, as p [ 0.05. Fibrinogen showed significant phase-to-phase reductions of plasmatic values. Lipid profile values showed a statistically significant decrease. The renal filtration function evaluated by plasma creatinine showed statistically significant improvement and, in terms of absolute values, creatinine level was reduced in a range between 0.2-0.4 mg/dL. Also, it was recorded a significantly lower level of blood urea. By comparing the Phase I and Phase III results, we observed that the median 10-year Framingham cardiovascular risk score was approximately 6% lower (p [0.05), reflecting the survival benefit gained by patients under the intensive cardiovascular recovery program.

(1) Background: The heart-type fatty acid-binding protein (H-FABP) is a specific myocardial biomarker and high levels indicate ischemia regardless of patient-reported symptoms. Concurrently, major adverse cardiovascular events and surgery such as coronary artery by-pass grafting (CABG) cause substantial psycho-emotional distress e.g., depression and anxiety. Comprehensive cardiac rehabilitation is, therefore, essential to both physical and psychological recovery. (2) Methods: This is a unicentric, prospective study on 120 consecutive post-CABG patients undergoing a 6-month cardiac rehabilitation program based on physical exercise, Mediterranean diet principles, and Q10 coenzyme antioxidant supplements. H-FABP levels, depression, and anxiety scores (Hamilton HAM-D and HAM-A scales) were monitored after surgery and at 6 months. (3) Results: Mean H-FABP dropped from 60.56 to 4.81. Physical ability increased from 1–2 to 4–5 METS. Mean depression and anxiety improved from 15.88 to 6.96 and from 25.13 to 15.68, respectively. Median scores went down 50% for depression and 9% for anxiety. Explored associations between H-FABP and psycho-emotional status were statistically insignificant. (4) Conclusions: patients adhered to the program and improved significantly in all studied aspects. Clinical significance is discussed in the context of countries like Romania, where such programs are limited by systemic and financial constraints. Further research directions are identified.

Abstract-Metabolic Syndrome (MetS), a cluster of more than three cardio-metabolic risk factors, is becoming a major worldwide health problem. CHAID analysis can bring to front the role of pathogenesis -represented by insulin resistance and measured by Reaven index, and the importance of twocumulated criteria -as the association of hypertension and obesity, in revealing the likelihood of developing MetS in patients that do not yet account for all condition criteria. The aim of our research was to stress the order of influence of a specific two-cumulated criterion comparative to other MetS criteria comprised into a pathogenic index -the Reaven index (comprising TG and HDL that are two independent MetS diagnosis criterion). CHAID Decision Tree Algorithm can become an intelligent system to support wise decision-making and to predict the likelihood of developing MetS in patients at lowrisk for this condition.

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Cardiovascular disease is one of the leading causes of morbid-mortality, although better outcomes and lower mortality of age-adjusted coronary artery disease were registered since 1980s, especially in high-income populations, sustaining the cost effective of cardiac prevention methods. The aim of this prospective study was to evaluate the role of cardiac rehabilitation in improving psycho-emotional risk scores: the Hamilton Depression (HAM-D) and Anxiety Rating Scale (HAM-A) in coronary artery bypass grafting (CABG) patients, in less than one week after cardiovascular surgery and in 6 months follow-up after the engagement in the cardiac recovery program. Methods – During 01.05.2015 – 01.03.2017, CABG was performed in 100 patients, aged 40-80 years old, who followed rehabilitation in the Cardiovascular Rehabilitation Clinic. The mean age of the patients under study was 65.70 ± 9.91 years old. Results – In the fi rst phase of the cardiovascular rehabilitation program, the mean values were: 16 points for HAM-D, and 25 points on HAM-A scale. By comparing the Phase I and Phase III results, the median HAM-D score improved more than 50%, and HAM-A about 36% (p<0.05). Conclusion – The study highlighted the role of early rehabilitation after CABG surgery and the HAM-D and HAM-A scores improvement, emphasizing the importance of including psycho-emotional status assessment in the management of the patient who benefi ted from cardiac surgery. Apart from clinical data and the cardiovascular risk scores, the psycho-emotional risk stratification can provide important information regarding outcomes and prognosis.