Abstract 4123: Cardiorespiratory Fitness, European Systematic Coronary Risk Evaluation and the Risk of Cardiovascular and All-Cause Death
Background: It is proposed that exercise capacity with the global risk scores may be provide additional information for risk stratification in asymptomatic subjects. However, there are no previous data on directly measured cardiorespiratory fitness combined with European Systematic Coronary Risk Evaluation with respect to death from cardiovascular diseases and all-causes.
Methods: The current study is based on a random population-based sample of 1639 men (42– 60 years) without history of type II diabetes or atherosclerotic cardiovascular disease including coronary heart disease, stroke or claudication. Cardiorespiratory fitness (peak oxygen uptake, VO2peak) was measured using exercise test with an electrically braked cycle ergometer and respiratory gas analyser. During an average follow-up of 16 years, a total of 304 all-cause deaths occurred and 114 deaths were due to cardiovascular causes.
Results: Independent predictors for all-cause death were European Score (for 1 % increment, RR 1.15, 95 % CI 1.10 to 1.20, p<0.001), VO2peak (for 1 MET increment, RR 0.83, 95 % CI 0.78 to 0.89, p<0.001), C-reactive protein (for 1 mmol/L increment, RR 1.05, 95 % CI 1.03 to 1.07, p<0.001) and alcohol consumption (for 100 g/week increment, RR 1.17, 95 % CI 1.09 to 1.27, p<0.001), when adjusted for serum high-density lipoprotein, waist-to-hip ratio, family history of coronary heart disease, exercise-induced ST changes and the use of medications for hypertension, dyslipidemia or aspirin. Adjusted risks were 4.20 (p<0.001) for all-cause death and 5.32 (p<0.001) for cardiovascular death among those with combination of poor VO2peak (≤27.5 mL/kg/min, lowest quartile) and high Score (> 5%) as compared to those with good VO2peak and low risk Score.
Conclusions: An important finding is that the European risk Score can be used to identify men for whom low cardiorespiratory fitness predicts an especially high risk for death from cardiovascular and any other cause.