Clinical InvestigationPrevention and RehabilitationCardiorespiratory fitness attenuates risk for major adverse cardiac events in hyperlipidemic men and women independent of statin therapy: The Henry Ford ExercIse Testing Project
Section snippets
Study design
This study is based on data from the Henry Ford ExercIse Testing Project (The FIT Project), a retrospective cohort study aimed at investigating the long-term implications of exercise capacity on cardiovascular outcomes and total mortality.47
The FIT Project is unique in its combined use of (1) directly measured exercise data, (2) retrospective collection of medical history and medication treatment data taken at the time of the stress test, (3) retrospective supplementation of supporting clinical
Baseline characteristics
Table I shows baseline characteristics and stress test results for the study population (n = 33,204), which included 14,774 (44%) women and 8,260 (25%) blacks. Online Appendix Supplementary Table I shows the lipid profile for the study population. Online Appendix Supplementary Table II shows the baseline characteristics by MET categories. Mean age of the study population was 57 ± 12 years. At baseline, 14,344 (43%) patients with hyperlipidemia were on statin therapy, of which 8,220 (57%) were
Discussion
Higher CRF was associated with markedly lower risk for mortality, MI, and subsequent revascularization in this multiethnic cohort of men and women with hyperlipidemia seen in routine clinical practice. The prognostic value of CRF was not diminished by baseline statin therapy, suggesting continued importance of CRF in all patients with hyperlipidemia.
Conclusion
Higher CRF was associated with lower risk for mortality, MIs, and subsequent revascularizations irrespective of gender and statin therapy in this cohort of patients with hyperlipidemia seen in routine clinical practice. The prognostic value of CRF was not diminished with statin therapy, suggesting that fitness remains an important consideration in all patients with hyperlipidemia, including those on statin therapy.
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Cited by (20)
Fitness attenuates long-term cardiovascular outcomes in women with ischemic heart disease and metabolic syndrome
2023, American Journal of Preventive CardiologyPrognostic Interplay Between Coronary Artery Calcium Scoring and Cardiorespiratory FItness: The CAC-FIT Study
2022, Mayo Clinic ProceedingsCitation Excerpt :Our study also provides important insight into the prognostic value of EC and CACS in patients taking statins. Prior studies from the Henry Ford ExercIse Testing (FIT) Project have reported how statin users achieved higher METs on exercise stress testing and that the prognostic role of METs was independent of statin therapy in patients with hyperlipidemia.27,28 However, the 2018 American Heart Association/American College of Cardiology cholesterol management guidelines, although acknowledging the role of CACS in intermediate-risk individuals, mentioned how CACS is of no benefit in patients taking statins.29
The relationship between cardiorespiratory fitness, cardiovascular risk factors and atherosclerosis
2020, AtherosclerosisCitation Excerpt :As such, in patients with low CRF and CHD, improvements in CRF using cardiac rehabilitation may help to lower mortality risk. A similar analysis from the FIT project included 9852 adults with known CAD who underwent physician-referred treadmill stress testing [43]. There were 3824 all-cause deaths during a mean follow-up of 11.6 ± 5 years.
Screening for Atherosclerotic Cardiovascular Disease in Asymptomatic Individuals
2018, Chronic Coronary Artery Disease: A Companion to Braunwald's Heart DiseaseImpact of Cardiorespiratory Fitness on All-Cause and Disease-Specific Mortality: Advances Since 2009
2017, Progress in Cardiovascular DiseasesCitation Excerpt :However, without an objective marker of effort, the attainment of true maximum is uncertain.31 In the ACLS, VA, and HFH cohorts, CRF was estimated from the attained speed, grade and duration at the highest stage of a treadmill exercise test.10–13,19,21–24,32–37 The prediction equations (separate equations for walking speeds, running speeds, and cycle workrates) used for this estimate were developed using steady-state, submaximal exercise levels.38
None of the authors have any relevant relations to industry to disclose. The present study was conducted in accordance with the Declaration of Helsinki and was approved by the Henry Ford Health System Institutional Review Board. An oral presentation of this study was presented at the American College of Cardiology Scientific Sessions in Washington, DC, on March 30, 2014. Poster presentations of this study were presented at Cardiovascular Disease Prevention International Symposium in Miami, FL, on February 6, 2014, and at the Johns Hopkins Heart and Vascular Institute's Cardiovascular Research Retreat in Baltimore, MD, on May 30, 2014.