Aerobic capacity, measured as the peak oxygen uptake, is a strong predictor of survival in cardiac patients. Aerobic interval training (AIT), walking/running four times four minutes at 85–95% of peak heart rate, has proven to be effective in increasing peak oxygen uptake in coronary heart disease patients. As some patients do not attend organized rehabilitation programs, home-based exercise should be an alternative. We investigated whether AIT could be performed effectively at home, and compared the effects on peak oxygen uptake with that observed after a standard care, four-week residential rehabilitation. Thirty patients undergoing coronary artery bypass surgery were randomized to residential rehabilitation or home-based AIT. At six months follow-up, peak oxygen uptake increased 4.6 (±2.7) and 3.9 (±3.6) mL·kg−1 min−1 (both p<0.005, non-significant between-group difference) after residential rehabilitation and AIT, respectively. Quality of life increased significantly in both groups, with no statistical significant difference between groups. We found no evidence for a different treatment effect between patients randomized to home-based AIT compared to patients attending organized rehabilitation (95% confidence interval −1.8, 3.5). AIT patients reported good adherence to exercise training. Even though these first data indicate positive effects of home-based AIT in patients undergoing coronary artery bypass surgery, more studies are needed to provide supporting evidence for the application of this rehabilitation strategy.Trial RegistrationClinicalTrials.gov NCT00363922

Topical application of autologous platelet-rich plasma on vein harvest wounds did not reduce the rate of surgical site infection.

Background Cardiovascular risk factor control is suboptimal in Europe, including Norway. The present study examined the efficacy of a multimodal primary prevention intervention program based on the existing Norwegian health care system. Methods In this open-label randomized controlled trial, adult patients with elevated cardiovascular risk were randomly assigned to an intervention program including a hospital-based lifestyle course and primary care follow-up or to a control group. The participants were recruited between 2011 and 2015. Primary outcome was change in validated cardiovascular risk scores (NORRISK, NORRISK 2, Framingham, PROCAM) between baseline and follow-up. Secondary outcomes included major cardiovascular risk factors. Results After 36 months the NORRISK score was significantly improved in patients assigned to the intervention group (IG) compared to patients assigned to the control group (CG); absolute difference in mean delta score in the IG (n = 305) compared to mean delta score in the CG (n = 296): -0,92, 95% CI: -1,48 to -0,36, p = 0,001. The results for NORRISK 2, Framingham and PROCAM showed similar significant effects. The secondary endpoints including total cholesterol and blood pressure were only minimally, and non-significantly, reduced in the IG, but the proportion of smokers (p = 0,0028) and with metabolic syndrome (p &lt; 0,0001) were significantly reduced. A limited number of cardiovascular events were observed, IG (n = 9), CG (n = 16). Conclusions In subjects with elevated cardiovascular risk, a newly developed prevention program, combining a hospital-based lifestyle course and primary care follow-up, significantly reduced cardiovascular risk scores after 36 months. This benefit appeared achievable primarily through improvements in metabolic syndrome characteristics and smoking habits.