Chronic inflammatory activation in fat tissue can be the link between adiposity and an increased risk for atherosclerosis. The aim of this study is to investigate how molecular alterations in fat tissue can be influenced by regular physical exercise training alone or in combination with a medical therapy (glitazone or metformin) in obese patients with severe coronary artery disease (CAD) and impaired glucose tolerance.

Inclusion Criteria:

• Either impaired glucose tolerance (2 hour plasma glucose concentration > 7.8 and < 11.1 mmol/L during an oral glucose tolerance test) or impaired fasting plasma glucose concentration ( > 6.0 and < 7.0 mmol/L)
• Body mass index (BMI) > 25
• Severe coronary artery disease determined by coronary angiography
• Male patients aged 35-75 years

Exclusion Criteria:

• Diabetes mellitus type I
• Diabetes mellitus type II in combination with glycosylates hemoglobin > 6.0%, previous medication with oral antidiabetic agents or insulin, fasting plasma glucose concentration > 11.0 mmol/L
• Unstable angina pectoris
• Myocardial infarction within the last 4 weeks
• Reduced left-ventricular systolic function < 30%