Abstract 15673: Gait Speed and Cardiovascular Events After Myocardial Infarction
Background: It is difficult to predict future cardiovascular events in patients with acute myocardial infarction (AMI). There are growing evidences that gait speed is inversely associated with all causes mortality and cardiovascular event rate among the elderly. However, this association has not been examined in patients with AMI. The purpose of this study is to evaluate the relationship between gait speed and cardiovascular events in patients restricted to AMI.
Methods: We enrolled 450 patients capable of walking with ST-segment elevation myocardial infarction (STEMI). All patients received reperfusion therapy within 12 hours from the onset. Gait speed during rehabilitation was measured at discharge. The primary endpoint was defined as a composite of cardiovascular death, non-fatal myocardial infarction (MI), and non-fatal stroke, for an average follow-up period of 5.5 years.
Results: The mean age was 63 ± 12 years old, and 83% were male. During 2472 person years of follow-up, 76 patients (16.9%) experienced the primary composite endpoint (cardiovascular death: 33 [7.3%], MI: 22 [5.9%], and stroke: 21 [4.7%]). By multivariate Cox proportional hazards analysis with backward algorithm, gait speed was a significant and independent predictor of the composite endpoint (hazard ratio [HR]: 3.09, 95% confidence interval [CI]: 2.14 to 4.46, p < 0.01, table). This risk ratio of slow gait speed (per tertile) for cardiovascular events differed markedly according to the age, and was the greatest in the highest tertile of age (lowest: HR: 1.54, 95% CI: 0.86 to 2.74; middle; HR: 3.52, 95% CI: 1.70 to 7.31; highest; HR 7.12, 95% CI: 2.42 to 21.9).
Conclusion: Slow gait speed is strongly associated with an increased risk of cardiovascular death, MI, and stroke in patients after STEMI. This excess risk of slow gait speed was marked in elderly patients. Gait speed is a simple and effective assessment that may identify vulnerable patients at higher risk of cardiovascular events after STEMI.
- © 2011 by American Heart Association, Inc.