Abstract 13463: High Cardiorespiratory Fitness Attenuates Risk of Short-Term Mortality After First Myocardial Infarction: The Henry Ford Hospital Exercise Testing (FIT) Project
BACKGROUND: Cardiorespiratory fitness is an established predictor of myocardial infarction (MI), however, its effect on short-term mortality (STM) after MI has not been fully described.
METHODS: This retrospective cohort study included 2,086 patients (62±12 years old, 39% women, 56% white), who underwent clinical treadmill stress testing at Henry Ford Hospital between 1991 and 2009 and suffered a first MI during follow-up (MI event rate = 5.6%, follow-up = 11.1±5.1 years). STM represents all-cause mortality within 28 days after MI. Patients were categorized into 4 fitness categories based on peak estimated METS achieved (<6, 6-9, 10-12, >12 METs). Logistic regression was used to assess the influence of fitness on risk of STM, adjusting for: age at baseline, gender, and race; history of smoking, obesity, hypertension, hyperlipidemia, diabetes, and coronary artery disease; use of pertinent medications; stress test indication; time to MI; year of MI; and the decision to revascularize in the peri-MI period.
RESULTS: STM was 10.7% (223/2,086 total MI events), with patients more likely to be older, less fit, have a history of hypertension, have more time between stress test and incident MI, and to have undergone a revascularization procedure in the peri-MI period (p<0.05). Those who survived MI were more likely to be obese. The STM was 13.9%, 10.7%, 6.9%, and 6.0% (p<0.001) in the <6, 6-9, 10-12, and >12 METS groups respectively. Adjusted regression model showed a decrease in STM with increasing METS categories, reaching significance in the highest 2 METS categories (Table 1). A 1 MET increase in fitness was associated with a 9% risk reduction in STM (OR=0.91, 95%CI 0.85-0.96, p=0.001).
CONCLUSION: Higher baseline cardiorespiratory fitness was independently associated with a decreased risk of STM following first MI.
Author Disclosures: G.E. Shaya: None. R.K. Hung: None. K. Nasir: None. R.S. Blumenthal: None. S.J. Keteyian: None. C.A. Brawner: None. W. Qureshi: None. M. Al-Mallah: None. M.J. Blaha: None.
- © 2014 by American Heart Association, Inc.