Low exercise capacity was strongly associated with increased cardiovascular mortality compared to high capacity in both men (HR 4.2; 95% CI 1.7-10.8) and women (HR 5.4; 95% CI 1.2-24.0).
Cohort (n=3,033)
Does low exercise capacity predict cardiovascular and all-cause mortality in subjects referred to clinical exercise testing?
Exercise capacity is a powerful predictor of long-term cardiovascular and all-cause mortality in both men and women referred for clinical exercise testing.
Effect estimate: HR 4.2 (95% CI 1.7, 10.8)
BACKGROUND: Exercise stress testing is used as a diagnostic and prognostic tool. We determined the prognostic significance of exercise test findings for cardiovascular (CVD) and all-cause mortality in men and women. MATERIAL AND METHODS: 3033 subjects underwent a symptom-limited bicycle exercise test. Exercise capacity was defined as the mean of last four minutes of exercise workload. RESULTS: During an average follow-up of 19 years, 186 (11.6%) CVD and 370 (20.6%) all-cause deaths in men and 57 (5.0%) CVD and 155 (12.5%) all-cause deaths in women occurred. Among exercise test variables (workload, ECG, BP, HR), exercise capacity was the strongest predictor of mortality. Low exercise capacity (1st quartile) was associated with a hazard ratio of 4.2 (95% CI: 1.7, 10.8) for CVD and 4.0 (95% CI: 2.5, 6.4) for all-cause mortality compared with high exercise capacity (4th quartile) among men and in women with a 5.4-fold (95% CI: 1.2, 24.0) risk for CVD and 2.3-fold (95% CI: 1.2, 4.3) risk for all-cause mortality, respectively. The relationship between other exercise test variables and mortality was much weaker. CONCLUSIONS: Among exercise test variables exercise capacity was the strongest predictor of CVD and all-cause mortality in both genders, and especially CVD deaths in women. Key Messages Exercise capacity was the most powerful predictor of CVD and all-cause mortality in both men and women. Low exercise capacity is a strong predictor of CVD death, especially among women.
Korpelainen et al. (2016) conducted a cohort in Subjects referred to clinical exercise testing (n=3,033). Low exercise capacity (1st quartile) vs. High exercise capacity (4th quartile) was evaluated on Cardiovascular mortality in men (HR 4.2, 95% CI 1.7, 10.8). Low exercise capacity was strongly associated with increased cardiovascular mortality compared to high capacity in both men (HR 4.2; 95% CI 1.7-10.8) and women (HR 5.4; 95% CI 1.2-24.0).