Abstract 15367: Optimal Gait Speed Cut-off Values According to Age and Gender in Predicting Cardiovascular Events in Patients after Acute Myocardial Infarction
Background: Gait speed is a simple marker of frailty, and is inversely related to cardiovascular mortality among the elderly. In addition, we previously reported the association of slow gait speed with increased risk of cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). Since gait speed is strongly related to gender and age, we sought to assess prognostic utility of gait speed and to determine its optimal cut-off values according to gender and age to predict subsequent cardiovascular events in patients with STEMI.
Methods: We undertook a prospective observational study of gait speed in 472 patients with successful reperfusion therapy within 12 hours of STEMI onset. Gait speeds were measured during 200-meter walk before discharge, and all patients were followed for cardiovascular events which consist of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke. Optimal cut-off values of gait speed were defined using Youden index, according to gender and age.
Results: During the 2592 person-years of follow-up, 83 patients (17.6%) experienced cardiovascular events. By multivariate Cox proportional hazard analysis, gait speed significantly predicted cardiovascular events (hazard ratio for 0.1 m/s increasing in gait speed: 0.70, 95% confidence interval: 0.623 to 0.787, p<0.001). The optimal cut-off values of gait speed were 1.03 m/s in male aged < 70 years, 0.94 m/s in male aged ≥ 70 years, 0.89 m/s in female aged < 70 years, and 0.69 m/s in female aged ≥ 70 years, respectively. Kaplan-Meier analyses using these cut-off values showed that patients with slower gait speed experienced higher subsequent cardiovascular event rate (Figure).
Conclusion: Slower gait speed was strongly associated with subsequent cardiovascular events, and we suggest to use different cut-off values of gait speed according to gender and age for risk stratification in patients with STEMI.
Author Disclosures: C. Kawashima: None. Y. Matsuzawa: None. H. Suzuki: None. E. Akiyama: None. N. Maejima: None. N. Iwahashi: None. K. Tsukahara: None. K. Hibi: None. M. Kosuge: None. T. Ebina: None. S. Umemura: Research Grant; Modest; Torii. Research Grant; Significant; Pfizer, Dainippon-Sumitomo, Astellas, Shionogi, Daiichi-Sankyo, MSD, Astrazeneca, Novartis, Nihon-Boehringer-Ingelheim. Honoraria; Modest; Shionogi, MSD, Kyowa-Hakko-Kirin. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan, Research Institute for Production Development, Novartis, Bayer, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer -Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca. Honoraria; Significant; MSD.
- © 2014 by American Heart Association, Inc.