Abstract 15155: Good Exercise Capacity Alleviates the Effect of High Coronary Atherosclerotic Burden on All-cause Mortality
Introduction: Both exercise capacity and coronary artery calcium score (CACS) have been reported to be important prognostic factors. It has not been well studied whether there is significant interaction between these two factors in influencing clinical outcome.
Hypothesis: The effect size of CACS on all-cause mortality is reduced by higher level of exercise tolerance.
Methods: From multicenter registry of health screening cohort, 26,286 subjects were included in the final dataset for analysis who underwent both coronary calcium scoring and treadmill exercise test. All-cause mortality data were obtained from national mortality registry.
Results: The mean age of study subjects was 54 ± 8 years and proportion of male subjects 81%. Median follow-up duration was 5.5 (interquartile range 3.6 - 7.5) years and 232 (0.9%) deaths occurred. In fully adjusted Cox’s proportional hazard model with interaction term, exercise capacity ≥ 10 METs (hazard ratio (HR) 0.684, 95% CI 0.483 - 0.971) and CACS ≥ 400 (HR 3.328, 95% CI 1.850 - 5.988) were significant predictors of mortality and the HR of CACS ≥ 400 in those with lower exercise capacity is estimated to be about three times of that in those with higher exercise capacity. (HR 3.328 in < 10 METs vs. 1.108 in ≥ 10 METs, p for interaction = 0.024) after adjustment for age, gender, fasting glucose, serum creatinine, serum ALT and serum albumin.
Conclusions: In subjects with higher exercise capacity, the effect of very high CACS on all-cause mortality was significantly smaller than in those with lower exercise capacity. Good physical fitness is likely to override, at least partially, the adverse effect of high coronary atherosclerotic burden.
Author Disclosures: J. Sung: None. J. Yoon: None. S. Choi: None. H. Chang: None.
- © 2015 by American Heart Association, Inc.