Resistance-based exercise intervention for patients with coronary artery disease and sarcopenia: a pilot randomized controlled trial

Abstract Aims Sarcopenia is a prominent prognostic indicator in patients with coronary artery disease (CAD). This study aimed to examine the feasibility and preliminary effects of a resistance-based exercise intervention in CAD patients with sarcopenia. Methods and results This pilot assessor-blinded two-arm randomized controlled trial recruited 40 CAD patients aged ≥60 years with sarcopenia (mean age: 69.1 ± 5.03 years; 52.5% male), assigning them in a 1:1 ratio to either usual care or a 12-week exercise intervention (60 min/session, 2 sessions/week). The intervention followed an individualized, progressive, resistance-based exercise protocol using easily accessible exercise equipment. A blended approach, including centre-based, home-based and online sessions, was adopted to improve compliance and sustain training effects. No serious adverse events were reported, and the overall attendance rate was 94%. Compared with the control group, the intervention group showed significantly better physical performance measured by the Short Physical Performance Battery [β = 0.522, 95% confidence interval (CI) = −2.712 to −0.665, P = 0.001, Hedges’ g = 0.637] and muscle strength measured by handgrip strength (β = −2.435, 95% CI = −4.618 to −0.252, P = 0.029, Hedges’ g = 0.552) at immediate post-intervention. However, these effects were not sustained at 3 months post-intervention. No significant between-group differences were detected in muscle mass, cardiac-related functional status, health-related quality of life, or psychological outcomes. The effect sizes for these outcomes at the two timepoints ranged from 0.155 to 0.750. Conclusion The resistance-based exercise intervention was feasible and acceptable for CAD patients with sarcopenia, improving their short-term physical performance and muscle strength. A full-scale trial with longer-term follow-up is warranted to evaluate its effects on functional muscle and cardiac-related clinical outcomes. Registration ClincialTrials.gov (NCT05497687).