Study: Exercise alone equal to creatine add-on during cardiac rehab

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While cardiac rehabilitation has been proven to increase physical performance, quality of life and lipid profiles in patients with coronary artery disease and chronic heart failure, use of a creatine supplement as an add-on to exercise fared just as well as an exercise-only rehabilitation strategy, according to study results published June 23 in Clinical Rehabilitation.

“Skeletal muscle strength and aerobic power are reduced in patients with coronary artery disease or chronic heart failure in comparison with healthy subjects of comparable age and gender,” the authors wrote. “Explicit skeletal muscle weakness and reduced aerobic power are associated with higher utilization of healthcare resources and with lower survival rates as compared with coronary artery disease patients with relatively preserved physical function.”

During the study, Véronique A. Cornelissen, MD, from the University of Leuven and KU Leuven in Leuven, Belgium, and colleagues compared the effects of an oral creatine supplement with an exercise program or exercise alone in 70 cardiac patients with a mean age of 57.5. Four patients were women, and 66 were men.

The researchers evaluated the patients over a three-month period and randomized them into two groups: 37 patients received a placebo and 33 patients received creatine supplements. Additionally, all patients endured resistance training and aerobic workouts three times per week for 90 minutes each session.

According to previous research, creatine, often found in diets with meat, can be effective in improving muscle strength particularly during exercise regimens. During the study, patients in the creatine arm were given a 9 mg dose of creatine mixture containing 5 g of creatine monohydrate (Creapur, Degussa), maltodextrine and a sweetner.

Cornelissen and colleagues looked at whether or not cardiorespiratory endurance, muscle strength and recovery was increased by the administration of creatine and also measured quality of life scores in patients.

During the study, patients underwent a bicycle test, an exercise test on an isokinetic dynamometer (MD) to determine muscle performance, had left ventricular ejection fractions calculated and were administered blood tests.

Results showed that overall, patients had a mean ejection fraction of 46.9; ejection fraction was below 35 percent in 10 patients (5 placebo; 5 creatine), between 35 and 50 percent in 30 patients (14 placebo; 16 creatine) and over 50 percent in 30 patients (18 placebo; 12 creatine).

“All parameters of muscle function significantly improved following cardiac rehabilitation (time effect P50.05), but contrary to our hypothesis, the magnitude of increase in muscle strength and/or endurance was not greater in the group with creatine supplementation,” the authors wrote.

Meanwhile, resting and peak heart rates showed similar results for both groups at baseline and after follow-up; however, resting heart rates decreased after cardiac rehabilitation while peak heart rates increased in both groups.

After evaluating quality of life for both groups researchers found that while quality of life increased after cardiac rehabilitation, the numbers were similar in both study arms.

“The results of the present study show that intake of oral creatine supplements, at a rate that is proven to be effective in stimulating the beneficial effects of exercise training in younger healthy subjects, is safe but did not enhance the benefits of cardiac rehabilitation in patients with coronary artery disease or chronic heart failure,” the authors concluded.