Abstract 17531: Functional Aerobic Capacity and Mortality Risk in Patients With and Without Diabetes
Background: We hypothesized that patients with diabetes mellitus (DM) with normal functional aerobic capacity (FAC) would have a mortality risk comparable to that of non-DM patients.
Methods: This is a retrospective cohort study of consecutive patients referred for treadmill exercise testing (TMET). We examined the relationship between FAC, calculated as % of age-sex predicted time on the treadmill test, and mortality in patients with or without DM. We excluded patients with history of coronary artery disease. Cox-proportional hazard regression was used to compare mortality in DM versus non-DM with adjustments for FAC, exercise test abnormalities (abnormal exercise ECG and abnormal heart rate recovery), medications (aspirin, β blockers and statins) and other risk factors (body mass index, hypertension, smoking and dyslipidemia).
Results: The final cohort included 37,004 patients of which 2,282 had DM. After a median follow-up of 12.3 years, 206 DM and 1,426 non-DM patients died. FAC was different between patients with and without DM (80 ± 22% vs 96 ± 24% respectively, p < .0001). Adjusting for age and gender, DM patients had a higher mortality than those without DM [Hazard ratio (HR), 1.75; 95% Confidence Interval (95% CI) (1.61-2.03); p < .0001)]. The association of DM and mortality was attenuated when FAC % was included as a covariate in the regression model [HR, 1.34; 95% CI (1.15-1.55); p < .0001] for DM versus non-DM). The magnitude of the association of DM with mortality did not change substantially when additional covariates were added to the model [HR, 1.33; 95% CI (1.14-1.56); p < .0001]. DM patients with FAC ≥ 90% were not at increased risk compared to patient without DM [HR, 1.05; 95% CI (0.78-1.41); p < 0.78].
Conclusion: While DM does appear to increase mortality, DM Patients with normal FAC do not appear to be at increased mortality risk compared with patients without DM, highlighting the importance of promoting an active lifestyle in patients with DM.
- © 2013 by American Heart Association, Inc.