Prognostic Value of Exercise Capacity in Patients With Coronary Artery Disease: The FIT (Henry Ford ExercIse Testing) Project

被引：62

作者：

Hung, Rupert K. ^{[1
]}

Al-Mallah, Mouaz H. ^{[2
,3
]}

McEvoy, John W. ^{[1
]}

Whelton, Seamus P. ^{[1
]}

Blumenthal, Roger S. ^{[1
]}

Nasir, Khurram ^{[1
]}

Schairer, John R. ^{[3
]}

Brawner, Clinton ^{[3
]}

Alam, Mohsen ^{[3
]}

Keteyian, Steven J. ^{[3
]}

Blaha, Michael J. ^{[1
]}

机构：

[1] Johns Hopkins Ciccarone Ctr Prevent Heart Dis, Baltimore, MD 21287 USA

[2] King Abdul Aziz Cardiac Ctr, Riyadh, Saudi Arabia

[3] Henry Ford Hlth Syst, Detroit, MI USA

来源：

MAYO CLINIC PROCEEDINGS | 2014年 / 89卷 / 12期

关键词：

ALL-CAUSE MORTALITY; CARDIORESPIRATORY FITNESS; PHYSICAL-ACTIVITY; CARDIAC REHABILITATION; CARDIOVASCULAR EVENTS; MEDICAL THERAPY; HEART-DISEASE; UNITED-STATES; OXYGEN INTAKE; OLDER MEN;

D O I：

10.1016/j.mayocp.2014.07.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To examine the prognostic value of exercise capacity in patients with nonrevascularized and revascularized coronary artery disease (CAD) seen in routine clinical practice. Patients and Methods: We analyzed 9852 adults with known CAD (mean +/- SD age, 61 +/- 12 years; 69% men [n = 6836], 31% black race [n = 3005]) from The Henry Ford ExercIse Testing (FIT) Project, a retrospective cohort study of patients who underwent physician-referred stress testing at a single health care system between January 1, 1991, and May 31, 2009. Patients were categorized by revascularization status (nonrevascularized, percutaneous coronary intervention [PCI], or coronary artery bypass graft [CABG] surgery) and by metabolic equivalents (METs) achieved on stress testing. Using Cox regression models, hazard ratios for mortality, myocardial infarction (MI), and downstream revascularizations were calculated after adjusting for potential confounders, including cardiac risk factors, pertinent medications, and stress testing indication. Results: There were 3824 all-cause deaths during median follow-up of 11.5 years. In addition, 1880 MIs, and 1930 revascularizations were ascertained. Each 1-MET increment in exercise capacity was associated with a hazard ratio (95% CI) of 0.87 (0.85-0.89), 0.87 (0.85-0.90), and 0.86 (0.84-0.89) for mortality; 0.98 (0.96-1.01), 0.88 (0.84-0.92), and 0.93 (0.90-0.97) for MI; and 0.94 (0.92-0.96), 0.91 (0.88-0.95), and 0.96 (0.92-0.99) for downstream revascularizations in the nonrevascularized, PCI, and CABG groups, respectively. In each MET category, the nonrevascularized group had similar mortality risk as and higher MI and downstream revascularization risk than the PCI and CABG surgery groups (P<.05). Conclusion: Exercise capacity was a strong predictor of mortality, MI, and downstream revascularizations in this cohort. Furthermore, patients with similar exercise capacities had an equivalent mortality risk, irrespective of baseline revascularization status. (C) 2014 Mayo Foundation for Medical Education and Research

引用

页码：1644 / 1654

页数：11

共 47 条

[1] 2011 Compendium of Physical Activities: A Second Update of Codes and MET Values [J].

Ainsworth, Barbara E. ;

Haskell, William L. ;

Herrmann, Stephen D. ;

Meckes, Nathanael ;

Bassett, David R., Jr. ;

Tudor-Locke, Catrine ;

Greer, Jennifer L. ;

Vezina, Jesse ;

Whitt-Glover, Melicia C. ;

Leon, Arthur S. .

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 2011, 43 (08) :1575-1581

[2] Rationale and Design of the Henry Ford ExercIse Testing Project (The FIT Project) [J].

Al-Mallah, Mouaz H. ;

Keteyian, Steven J. ;

Brawner, Clinton A. ;

Whelton, Seamus ;

Blaha, Michael J. .

CLINICAL CARDIOLOGY, 2014, 37 (08) :456-461

[3] Cardiorespiratory Fitness and Long-Term Survival in "Low-Risk" Adults [J].

Barlow, Carolyn E. ;

DeFina, Laura F. ;

Radford, Nina B. ;

Berry, Jarett D. ;

Cooper, Kenneth H. ;

Haskell, William L. ;

Jones, Lee W. ;

Lakoski, Susan G. .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2012, 1 (04)

[4] Physical Fitness and Risk for Heart Failure and Coronary Artery Disease [J].

Berry, Jarett D. ;

Pandey, Ambarish ;

Gao, Ang ;

Leonard, David ;

Farzaneh-Far, Ramin ;

Ayers, Colby ;

DeFina, Laura ;

Willis, Benjamin .

CIRCULATION-HEART FAILURE, 2013, 6 (04) :627-634

[5] Optimal medical therapy with or without PCI for stable coronary disease [J].

Boden, William E. ;

O'Rourke, Robert A. ;

Teo, Koon K. ;

Hartigan, Pamela M. ;

Maron, David J. ;

Kostuk, William J. ;

Knudtson, Merril ;

Dada, Marcin ;

Casperson, Paul ;

Harris, Crystal L. ;

Chaitman, Bernard R. ;

Shaw, Leslee ;

Gosselin, Gilbert ;

Nawaz, Shah ;

Title, Lawrence M. ;

Gau, Gerald ;

Blaustein, Alvin S. ;

Booth, David C. ;

Bates, Eric R. ;

Spertus, John A. ;

Berman, Daniel S. ;

Mancini, G. B. John ;

Weintraub, William S. ;

Boden, W. ;

O'Rourke, R. ;

Teo, K. ;

Hartigan, P. ;

Weintraub, W. ;

Maron, D. ;

Mancini, J. ;

Weintraub, W. ;

Boden, W. ;

O'Rourke, R. ;

Teo, K. ;

Hartigan, P. ;

Knudtson, M. ;

Maron, D. ;

Bates, E. ;

Blaustein, A. ;

Booth, D. ;

Carere, R. ;

Ellis, S. ;

Gosselin, G. ;

Gau, G. ;

Jacobs, A. ;

King, S., III ;

Kostuk, W. ;

Harris, C. ;

Spertus, J. ;

Peduzzi, P. .

NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (15) :1503-1516

[6] Patterns and Intensity of Medical Therapy in Patients Undergoing Percutaneous Coronary Intervention [J].

Borden, William B. ;

Redberg, Rita F. ;

Mushlin, Alvin I. ;

Dai, David ;

Kaltenbach, Lisa A. ;

Spertus, John A. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2011, 305 (18) :1882-1889

[7] Familial resemblance for VO2max in the sedentary state:: the HERITAGE Family Study [J].

Bouchard, C ;

Daw, EW ;

Rice, T ;

Pérusse, L ;

Gagnon, J ;

Province, MA ;

Leon, AS ;

Rao, DC ;

Skinner, JS ;

Wilmore, JH .

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 1998, 30 (02) :252-258

[8] Genomic predictors of the maximal O2 uptake response to standardized exercise training programs [J].

Bouchard, Claude ;

Sarzynski, Mark A. ;

Rice, Treva K. ;

Kraus, William E. ;

Church, Timothy S. ;

Sung, Yun Ju ;

Rao, D. C. ;

Rankinen, Tuomo .

JOURNAL OF APPLIED PHYSIOLOGY, 2011, 110 (05) :1160-1170

[9] MAXIMAL OXYGEN INTAKE AND NOMOGRAPHIC ASSESSMENT OF FUNCTIONAL AEROBIC IMPAIRMENT IN CARDIOVASCULAR DISEASE [J].

BRUCE, RA ;

KUSUMI, F ;

HOSMER, D .

AMERICAN HEART JOURNAL, 1973, 85 (04) :546-562

[10] The Bypass Angioplasty Revascularization Investigation 2 Diabetes Randomized Trial of Different Treatment Strategies in Type 2 Diabetes Mellitus With Stable Ischemic Heart Disease Impact of Treatment Strategy on Cardiac Mortality and Myocardial Infarction [J].

Chaitman, Bernard R. ;

Hardison, Regina M. ;

Adler, Dale ;

Gebhart, Suzanne ;

Grogan, Mary ;

Ocampo, Salvador ;

Sopko, George ;

Ramires, Jose A. ;

Schneider, David ;

Frye, Robert L. .

CIRCULATION, 2009, 120 (25) :2529-U44

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