Among 69,885 patients undergoing treadmill stress testing, 17% had severely reduced fitness (METs < 6), and overall rates of mortality, MI, and revascularization were 15.9%, 5.6%, and 6.7%.
Cohort (n=69,885)
Yes
Does physical fitness level predict death, myocardial infarction, and need for coronary revascularization in physician-referred patients undergoing treadmill stress testing?
The FIT Project is a large retrospective cohort study demonstrating the feasibility of using linked electronic medical records and exercise data to evaluate the prognostic value of physical fitness on cardiovascular outcomes.
Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population-based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low-cost, epidemiologic studies leveraging electronic medical record (EMR) data, we describe the rationale and design of the Henry Ford ExercIse Testing Project (The FIT Project). The FIT Project is unique in its combined use of directly measured clinical exercise data retrospective collection of medical history and medication treatment data at the time of the stress test, retrospective supplementation of supporting clinical data using the EMR and administrative databases and epidemiologic follow-up for cardiovascular events and total mortality via linkage with claims files and the death registry. The FIT Project population consists of 69 885 consecutive physician-referred patients (mean age, 54 ± 10 years; 54% males) who underwent Bruce protocol treadmill stress testing at Henry Ford Affiliated Hospitals between 1991 and 2009. Patients were followed for the primary outcomes of death, myocardial infarction, and need for coronary revascularization. The median estimated peak metabolic equivalent (MET) level was 10, with 17% of the patients having a severely reduced fitness level (METs < 6). At the end of the follow-up duration, 15.9%, 5.6%, and 6.7% of the patients suffered all-cause mortality, myocardial infarction, or revascularization procedures, respectively. The FIT Project is the largest study of physical fitness to date. With its use of modern electronic clinical epidemiologic techniques, it is poised to answer many clinically relevant questions related to exercise capacity and prognosis.
Al‐Mallah et al. (Fri,) conducted a cohort in Physician-referred patients undergoing stress testing (n=69,885). Cardiorespiratory fitness (peak MET level) was evaluated on Death, myocardial infarction, and need for coronary revascularization. Among 69,885 patients undergoing treadmill stress testing, 17% had severely reduced fitness (METs < 6), and overall rates of mortality, MI, and revascularization were 15.9%, 5.6%, and 6.7%.
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