Affiliation:
1. Cardiovascular Health Clinic, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
2. Cedars Sinai Medical Center, Los Angeles, CA
3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
Abstract
Background
Exercise testing provides valuable information in addition to
ST
‐segment changes. The present study evaluated the associations among exercise test parameters and all‐cause mortality in a referral population.
Methods and Results
We examined conventional cardiovascular risk factors and exercise test parameters in 6546 individuals (mean age 49 years, 58% men) with no known cardiovascular disease who were referred to our clinic for exercise stress testing between 1993 and 2003. The association of exercise parameters with mortality was assessed during a follow‐up of 8.1±3.7 years. A total of 285 patients died during the follow‐up period. Adjusting for age and sex, the variables associated with mortality were: smoking, diabetes, functional aerobic capacity (
FAC
), heart rate recovery (
HRR
), chronotropic incompetence, and angina during the exercise. Adjusting for cardiovascular risk factors (diabetes, smoking, body mass index, blood pressure, serum total,
HDL
,
LDL
cholesterol, and triglycerides) and other exercise variables in a multivariable model, the only exercise parameters independently associated with mortality were lower
FAC
(adjusted hazard ratio [
HR
] per 10% decrease in
FAC
, 1.21; 95% confidence interval [
CI
], 1.13 to 1.29;
P
<0.001), and abnormal
HRR
, defined as failure to decrease heart rate by 12 beats at 1 minute recovery (adjusted
HR
per 1‐beat decrease, 1.05; 95%
CI
, 1.03 to 1.07;
P
<0.001). The additive effects of
FAC
and
HRR
on mortality were also highly significant when considered as categorical variables.
Conclusion
In this cohort of patients with no known cardiovascular disease who were referred for exercise electrocardiography,
FAC
and
HRR
were independently associated with all‐cause mortality.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
52 articles.
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