The Duke treadmill score with bicycle ergometer: Exercise capacity is the most important predictor of cardiovascular mortality
Key result
The Duke treadmill score predicted cardiovascular mortality (FINCAVAS HR 3.15, 95% CI 1.83-5.42; KIHD HR 1.71, 95% CI 1.34-2.18), but exercise capacity in METs was the dominant predictor.
Why the study?
Does the Duke treadmill score derived from bicycle exercise testing predict cardiovascular mortality?
Population
6,619 patients from two Finnish cohorts: 3,936 patients referred for exercise testing and 2,683 men from a…
Design
Cohort
Follow-up
Median 6.3 years (FINCAVAS) and 24.1 years (KIHD)
Authors
Discussion
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Member takes
Implication
Exercise capacity should guide CV risk stratification over Duke score; extends prognostic data but subordinates Duke utility to METs.
Study Design
Type
Cohort (n=6,619)
Multicenter
Yes
Structured PICO
Does the Duke treadmill score derived from bicycle exercise testing predict cardiovascular mortality?
P
Population
6,619 individuals from two Finnish cohorts undergoing standard bicycle testing, followed for a median of 6.3 and 24.1 years to assess cardiovascular mortality.
E
Exposure
Duke treadmill score and its individual components (exercise capacity in metabolic equivalents of task, maximum ST-segment deviation, and exercise-induced angina) assessed via standard bicycle exercise testing.
O
Outcome
Cardiovascular mortalityhard clinical
Main Result
Hazard Ratio: 3.15 (95% CI 1.83–5.42)
p-value: p=<0.001
While the Duke treadmill score derived from bicycle testing predicts cardiovascular mortality, its exercise capacity component (measured in METs) is the dominant and superior predictor of poor prognosis.
Cite This Study
Salokari et al. (2018) conducted a cohort in Cardiovascular risk assessment (n=6,619). Duke treadmill score vs. Lowest Duke treadmill score tertile was evaluated on Cardiovascular mortality (HR 3.15, 95% CI 1.83-5.42, p=<0.001). The Duke treadmill score predicted cardiovascular mortality (FINCAVAS HR 3.15, 95% CI 1.83-5.42; KIHD HR 1.71, 95% CI 1.34-2.18), but exercise capacity in METs was the dominant predictor.