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Randomised controlled trial in women with coronary artery disease investigating the effects of aerobic interval training versus moderate intensity continuous exercise in cardiac rehabilitation: CAT versus MICE study
  1. Leanna S Lee1,2,
  2. Ming-Chang Tsai3,
  3. Dina Brooks1,2,4,5,
  4. Paul I Oh2
  1. 1Institute of Medical Science, University of Toronto, Ontario, Canada
  2. 2Cardiac Rehabilitation, Toronto Rehabilitation Institute - Rumsey Centre, Toronto, Ontario, Canada
  3. 3Department of Biomechanics and Performance Analysis, Canadian Sport Institute Pacific, Victoria, British Colombia, Canada
  4. 4Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
  5. 5School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Leanna S Lee; leanna.lee{at}


Background The primary aim of the present study was to investigate the effects of aerobic interval training (AIT) versus moderate intensity continuous exercise (MICE) on aerobic exercise capacity (V̇O2peak), in women only, with coronary artery disease (CAD) and who were referred to a large, 24-week outpatient cardiac rehabilitation (CR) programme. Secondary objectives included comparing the effects of AIT versus MICE on cognition, cardiovascular risk profile, adherence and quality of life before and after the 24-week CR programme.

Methods Thirty-one postmenopausal women with CAD (left ventricular ejection fraction >35%; 68.2±9.2 years of age; V̇O2peak: 19.1±3.5 mL kg-1 min-1) were randomised to 24 weeks of usual care MICE (60%–80% of V̇O2peak, five times per week) or AIT (four 4-min intervals at 90%–95% of peak heart rate, three times per week+two times per week usual care MICE). Differences between and within groups were assessed using independent samples t-tests and paired samples t-tests, respectively. Treatment effect analysis of AIT on V̇O2peak and secondary outcomes was determined using analysis of covariance with baseline values as covariates.

Results A randomised controlled trial study design was unfeasible in this female CAD population. Unanticipated challenges in recruitment availability and eligibility, in combination with a 59% and 50% attrition rate in the AIT and MICE group, respectively, rendered this study underpowered to detect differences between groups. The per protocol treatment effect analysis, however, unveiled a 0.95 mL kg-1 min-1 improvement in V̇O2peak in response to AIT over MICE (p<0.001).

Conclusions Further research is necessary to elucidate the patient profile and circumstances under which the potential for the implementation of AIT may be individualised, and offered in clinical practice.

Trial registration NCT02966158.

  • coronary artery disease
  • interval training
  • women
  • aerobic exercise capacity
  • cardiac rehabilitation

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  • Contributors LSL, DB, M-CT and PIO contributed to the conceptual design of the study. M-CT and LSL provided the statistical analysis for the data. LSL and PIO provided the clinical interpretation of all of the patient data. LSL wrote the manuscript, and PIO and DB critically reviewed it, and all authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the University Health Network Research Ethics Board (ID#16–5900).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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