Clinical InvestigationCoronary Artery DiseasePeak aerobic capacity predicts prognosis in patients with coronary heart disease
Section snippets
Study population
Between January 1996 and December 2004, we assessed 2,812 consecutive patients with a recent acute cardiac event requiring hospitalization that resulted in referral and entry into cardiac rehabilitation in Detroit, MI (n = 1,392), and Burlington, VT (n = 1,420). Cardiopulmonary exercise testing was performed (vs standard stress testing) as a standard baseline evaluation for cardiac rehabilitation entrants for both clinical and research purposes. If more than one cardiac diagnosis was recorded
Results
Table I describes demographic, clinical, and peak exercise characteristics for patients in this study. Of the total sample, 83% of patients were taking an antiplatelet agent, 75% of patients were taking a β-adrenergic receptor blocking agent, and 61% of patients were on a lipid-lowering agent; and 1,391 (∼50%) patients reported taking an evidence-based medical regimen consistent with their index event. Median follow-up period was 59 months and there were 280 total deaths.
Among men, univariable
Discussion
The primary finding of this article is that peak Vo2 remains an independent predictor of all-cause and cardiovascular-specific mortality in men and women, as determined in a cohort of patients (N = 2,812) with cardiovascular disease and referred to cardiac rehabilitation. In this group of patients, all were assessed during treadmill testing and most patients were being treated with agents consistent with contemporary evidence-based guidelines. Based on these findings, we accept our original
References (15)
- et al.
Prognostic significance of peak exercise capacity in patients with coronary artery disease
J Am Coll Cardiol
(1994) - et al.
Peak oxygen uptake and cardiac mortality in women referred for cardiac rehabilitation
J Am Coll Cardiol
(2003) - et al.
American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee to update the 1997 exercise testing guidelines. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines)
J Am Coll Cardiol
(2002) - et al.
A comparison of the reproducibility and physiologic responses to three maximal treadmill exercise protocols
Chest
(1974) - et al.
Prediction of long-term prognosis in 12 169 men referred for cardiac rehabilitation
Circulation
(2002) - et al.
Exercise capacity and mortality among men referred for exercise testing
N Engl J Med
(2002) - et al.
Assessment of functional capacity in clinical research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing
Circulation
(2007)
Cited by (270)
Assessing cardiorespiratory fitness in clinical and community settings: Lessons and advancements in the 100th year anniversary of VO<inf>2max</inf>
2024, Progress in Cardiovascular DiseasesA preoperative supervised exercise program potentially improves long-term survival after elective abdominal aortic aneurysm repair
2024, Journal of Vascular SurgeryTime-Restricted Eating: A Novel Dietary Strategy for Cardiac Rehabilitation
2023, Canadian Journal of CardiologyHow little is enough? The feasibility of conducting a dose-escalation study for exercise training in people with stroke
2023, Journal of Stroke and Cerebrovascular Diseases