Abstract 2986: Combination of Cardiorespiratory fitness and European Risk Score in the Prediction of Acute Coronary Events and Stroke
Introduction: Our studies have shown the associations of poor cardiorespiratory fitness with an increased risk of coronary heart disease and stroke. The role of cardiorespiratory fitness among subjects with high and low European risk scores with respect to atherosclerotic cardiovascular events is not well known, although it is suggested that the global risk score may be used for risk stratifying in asymptomatic individuals.
Methods: In this prospective study, cardiorespira-tory fitness (maximal oxygen uptake) was measured on an electrically braked cycle ergometer with respiratory gas analyses at baseline. The study is based on a population sample of 1639 men (42– 60 years) with no history of type II diabetes, coronary heart disease, stroke or claudication. Those who had European risk score over 5 % and low maximal oxygen uptake ≤ 31.8 ml/kg/min were the high risk group. During an average follow-up of 13.4 years, a total of 155 acute coronary events and 61 ischemic strokes occurred.
Results: The risk of acute coronary events was 4.48-fold (95% CI 2.71- 7.42, p < 0.001) among men with high European risk score and low maximal oxygen uptake and 2.46-fold (95 % CI 0.88 – 6.88, p = 0.087) among those who had high European risk score but good maximal oxygen uptake, as compared to those low European risk score and good maximal oxygen uptake, after adjustment for risk factors (CRP, alcohol, atrial fibrillation, exercise-induced ST changes, medication for hypertension or dyslipidemia and the use of aspirin, waist-to-hip ratio, serum HDL-cholesterol and physical activity). Furthermore, the respective risk for ischemic stroke was 3.44 (95 % CI 1.40 – 8.50, p = 0.009). In an multivariable adjusted model, 1 % increase in European risk score was associated with the risk of acute coronary events (RR 1.16, 95 % CI 1.09–1.24, p < 0.001) and ischemic stroke (RR 1.16, 95 % CI 1.05–1.28, p = 0.005), whereas VO2max (for 1 MET increment) was inversely related to the risk of acute coronary events (RR 0.87, 95 % CI 0.79 – 0.95, p = 0.002) and ischemic stroke (RR 0.86, 95 % CI 0.74 – 0.99, p = 0.045)
Conclusion: This prospective study shows that cardiorespiratory fitness together with European risk score risk maybe used as a screening tool in asymptomatic individuals for acute coronary events and ischemic stroke.