The Duke treadmill score with bicycle ergometer : Exercise capacity is the most important predictor of cardiovascular mortality
Salokari, E., Laukkanen, J., Lehtimäki, T., Kurl, S., Kunutsor, S., Zaccardi, F., Viik, J., Lehtinen, R., Nikus, K., Kööbi, T., Turjanmaa, V., Kähönen, M., & Nieminen, T. (2019). The Duke treadmill score with bicycle ergometer : Exercise capacity is the most important predictor of cardiovascular mortality. European Journal of Preventive Cardiology, 26(2), 199-207. https://doi.org/10.1177/2047487318804618
Julkaistu sarjassa
European Journal of Preventive CardiologyTekijät
Päivämäärä
2019Tekijänoikeudet
© The European Society of
Cardiology 2018.
Background: The Duke treadmill score, a widely used treadmill testing tool, is a weighted index combining exercise
time or capacity, maximum ST-segment deviation and exercise-induced angina. No previous studies have investigated
whether the Duke treadmill score and its individual components based on bicycle exercise testing predict cardiovascular
death.
Design: Two populations with a standard bicycle testing were used: 3936 patients referred for exercise testing (2371
men, age 56 13 years) from the Finnish Cardiovascular Study (FINCAVAS) and a population-based sample of 2683 men
(age 53 5.1 years) from the Kuopio Ischaemic Heart Disease study (KIHD).
Methods: Cox regression was applied for risk prediction with cardiovascular mortality as the primary endpoint.
Results: In FINCAVAS, during a median 6.3-year (interquartile range (IQR) 4.5–8.2) follow-up period, 180 patients
(4.6%) experienced cardiovascular mortality. In KIHD, 562 patients (21.0%) died from cardiovascular causes during the
median follow-up of 24.1 (IQR 18.0–26.2) years. The Duke treadmill score was associated with cardiovascular mortality
in both populations (FINCAVAS, adjusted hazard ratio (HR) 3.15 for highest vs. lowest Duke treadmill score tertile, 95%
confidence interval (CI) 1.83–5.42, P < 0.001; KIHD, adjusted HR 1.71, 95% CI 1.34–2.18, P < 0.001). However, after
progressive adjustment for the Duke treadmill score components, the score was not associated with cardiovascular
mortality in either study population, as exercise capacity in metabolic equivalents of task was the dominant harbinger of
poor prognosis.
Conclusions: The Duke treadmill score is associated with cardiovascular mortality among patients who have undergone
bicycle exercise testing, but metabolic equivalents of task, a component of the Duke treadmill score, proved to be a
superior predictor.
...
Julkaisija
Sage Publications Ltd.ISSN Hae Julkaisufoorumista
2047-4873Asiasanat
Julkaisu tutkimustietojärjestelmässä
https://converis.jyu.fi/converis/portal/detail/Publication/28689193
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