What question did this study set out to answer?

To assess the prognostic value of submaximal treadmill exercise testing for predicting cardiovascular and all-cause mortality in asymptomatic men.

August 1, 1986CirculationOpen Access

Predictive value of the exercise tolerance test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up Study.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: No history of myocardial infarction (n=3600). Intervention: Positive exercise tolerance test vs. Negative exercise tolerance test. Primary outcome: Cumulative mortality from cardiovascular disease (RR 4.6).

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Key result

A positive submaximal treadmill exercise tolerance test strongly predicted cardiovascular mortality compared to a negative test (11.9% vs 1.2%; age-adjusted RR 4.6) in men without prior MI.

Why the study?

Does a positive submaximal treadmill exercise tolerance test predict cardiovascular mortality in men without a history of myocardial infarction?

Population

More than 3600 white men, aged 30 to 79 years, without a history of myocardial infarction.

Comparison

Positive submaximal treadmill exercise tolerance… vs Negative submaximal treadmill exercise tolerance…

Design

Cohort

Follow-up

mean 8.1 to 8.6 years

Authors

DGDavid J. GordonUniversity of Iowa LEL G EkelundUniversity of North Carolina at Chapel Hill JKJ M KaronUniversity of North Carolina at Chapel Hill

Discussion

Member takes

Implication

May aid risk stratification in men without prior MI; leaves open whether screening improves outcomes in trials.

Key Points

To assess the prognostic value of submaximal treadmill exercise testing for predicting cardiovascular and all-cause mortality in asymptomatic men.
Evaluated >3,600 white men aged 30–79 years with no prior history of myocardial infarction as part of the Lipid Research Clinics Mortality Follow-up Study.
Conducted submaximal treadmill exercise tolerance tests, defining a positive test as ST-segment depression ≥1 mm by visual coding or ≥10 µV-sec by computer integral.
Monitored participants over a mean follow-up of 8.1 to 8.6 years while recording baseline blood pressure, smoking status, glucose, and plasma lipid levels.
Cardiovascular mortality occurred in 11.9% (22/185) of men with a positive exercise test over 8.1 years versus 1.2% (36/2993) of men with a negative test over 8.6 years (unadjusted RR 9.3; age-adjusted RR 4.6).
Participants with strongly positive ischemic exercise tests exhibited particularly marked cardiovascular mortality risk (unadjusted RR 15.6; age-adjusted RR 5.1).
A positive test predicted cardiovascular death more strongly than LDL cholesterol, HDL cholesterol, smoking, hyperglycemia, or hypertension, conferring an impact equivalent to a 17.4-year age increase.

Study Design

Type

Cohort (n=3,600)

Multicenter

Yes

Structured PICO

Does a positive submaximal treadmill exercise tolerance test predict cardiovascular mortality in men without a history of myocardial infarction?

Population

More than 3600 white men, aged 30 to 79 years, without a history of myocardial infarction.

Intervention

Positive submaximal treadmill exercise tolerance test (ST segment depression ≥1 mm and/or 10 microV-sec)

Comparator

Negative submaximal treadmill exercise tolerance test

Outcome

Cumulative mortality from cardiovascular diseasehard clinical

Main Result

Effect estimate: RR 4.6

Absolute Event Rate: 11.9% vs 1.2%

A positive submaximal treadmill exercise test is a strong, independent predictor of cardiovascular and all-cause mortality in men without a history of myocardial infarction.

Cite This Study

Gordon et al. (1986) conducted a cohort in No history of myocardial infarction (n=3,600). Positive exercise tolerance test vs. Negative exercise tolerance test was evaluated on Cumulative mortality from cardiovascular disease (RR 4.6). A positive submaximal treadmill exercise tolerance test strongly predicted cardiovascular mortality compared to a negative test (11.9% vs 1.2%; age-adjusted RR 4.6) in men without prior MI.

synapsesocial.com/papers/6a10780f12e2385ed3fe2831 https://doi.org/10.1161/01.cir.74.2.252

Topics

Hypertension management

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Predictive value of the exercise tolerance test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up Study.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Predictive value of the exercise tolerance test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up Study.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider