Abstract 15608: Independent association Between Exercise Testing Parameters and Cardiovascular Events Beyond Traditional Risk Factors in People without History of Cardiovascular Disease
Introduction: We investigated whether exercise treadmill test (ETT) parameters and conventional cardiovascular (CV) risk factors contribute independently to adverse cardiovascular events in a coronary-disease-free Olmsted-County cohort.
Methods: This retrospective cohort study included consecutive Olmsted County residents undergoing a screening symptom-limited ETT at Mayo Clinic between 1990-2003. Baseline demographics and conventional CV risk factors were ascertained from the CV Health Clinic/ETT database. The primary outcome was a composite of incident myocardial infarction, coronary revascularization, and cardiovascular death. Cox Proportional Hazards regression was used to test for an independent association between risk factors and primary outcome.
Results: The cohort consisted of 6546 consecutive adults (mean age 49 ± 8 years, range18- 92 years, 58 % men). During a mean follow-up of 8.1 (±3.7) years, a total of 535 (8.2%) events occurred. Conventional CV risk factors independently associated with primary outcome were older age, male sex, higher low-density lipoprotein, and lower high-density lipoprotein cholesterol, and hypertension therapy (Table 1). ETT parameters independently associated with adverse CV events were lower exercise capacity, chronotropic incompetence, hypotensive blood-pressure response, ischemic ST segment changes, and typical angina during exercise.
Conclusion: Even in the era of better preventive strategies, conventional CV risk factors are associated with increased CV mortality. ETT provided additional incremental information to predict CV events in adults from the community referred for screening ETT.
- © 2011 by American Heart Association, Inc.