Integrating multiple exercise test parameters with classical risk factors was clearly superior to classical risk factors alone for predicting CHD mortality over 26 years (P < 0.0001).
Cohort (n=2,014)
Does integrating multiple exercise test parameters with conventional risk factors improve CHD risk assessment in apparently healthy men?
Integration of multiple exercise test parameters with conventional risk factors substantially improves CHD risk assessment, particularly in high-risk individuals such as smokers with high cholesterol.
p-value: p=< 0.0001
AIM: It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters. METHODS AND RESULTS: In 1972-75, 2014 apparently healthy men aged 40-60 had a symptom limited exercise test during a cardiovascular survey. Three hundred died from CHD during 26 years of follow-up. Compared to Cox regression models solely including classical risk factors (CRF), models also including multiple exercise test parameters (CRF+X) were clearly superior (P 6.5 mmol/l (n = 470), the CRF and CRF+X models identified 67 vs. 110 men at the highest CHD risk level according to European guidelines (34.2% vs. 38.2% CHD mortality). Three in five CRF+X-identified smokers with cholesterol >6.5 mmol/l had CHD mortality similar to the mean of all 2014 men. CONCLUSION: Integration of multiple exercise test parameters and conventional risk factors improved CHD risk assessment substantially--especially in smokers with high cholesterol.
G ERIKSSEN (Sat,) conducted a cohort in CHD risk assessment (n=2,014). Classical risk factors plus multiple exercise test parameters (CRF+X) vs. Classical risk factors alone (CRF) was evaluated on CHD mortality (p=< 0.0001). Integrating multiple exercise test parameters with classical risk factors was clearly superior to classical risk factors alone for predicting CHD mortality over 26 years (P < 0.0001).