LAUSR

High-density lipoprotein cholesterol (HDL-C) and Cardiac Rehabilitation (CR) are both established beneficial factors in managing patients with Coronary Artery Disease (CAD). Despite numerous attempts to manipulate serum HDL-C levels, CR's impact on HDL-C levels requires further investigation. To analyze changes in HDL-C levels following a phase II Exercise-Based CR Program in patients with established CAD and identify predictors of HDL-C elevation. This single-center, retrospective observational study included consecutive patients who successfully completed a supervised Exercise-Based CR Program (January 2023–September 2024), with a minimum duration of 12 weeks. Data were collected at baseline and at the completion of Phase II CR by a specialized multidisciplinary team. Paired T-Tests or Wilcoxon signed-rank tests were used for continuous variables, and Chi-Square tests for categorical variables. Patients were stratified by the presence or absence of a ≥5% increase in HDL-C, and Bivariate Logistic Regression was used to estimate odds ratios (ORs) with 95% confidence intervals (95% CIs). The cohort comprised a total of 53 patients, primarily males (44/83.3%), with a mean age of 59.6 ± 11.1 years. The mean program duration was 20.0 ± 8.0 weeks. Post-rehabilitation HDL-C levels differed significantly (40.0 (IQR 12.0) vs. 42.1 (IQR 12.0) mg/dL, p-value = 0.027), with more patients achieving target HDL-C levels (10/18.9 vs. 14/29.2%, p-value = 0.003). Multivariable binary logistic regression revealed that a higher baseline systemic inflammatory index (SII), calculated through the product between neutrophils and platelet counts, divided by the total lymphocyte count, was associated with a greater likelihood of HDL-C elevation (p-value = 0.48, adjusted OR = 1.06, 95% CI 1.01-1.12). In this cohort, patients with lower baseline SII values exhibited a 6% increased odd of improved HDL-C levels following phase II CR. Our results suggest that the improvement in HDL-C levels following phase II CR may be mediated by a reduction in systemic inflammation, as indicated by the association between lower baseline SII and a higher likelihood of HDL-C elevation. Further research is needed to confirm this hypothesis and elucidate whether this association is mediated by a reduction in systemic inflammation.