Maximal exercise test as a predictor of risk for mortality from coronary heart disease in asymptomatic men
Maximal exercise test as a predictor of risk for mortality from coronary heart disease in asymptomatic men
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DOI：
10.1016/s0002-9149(00)00827-4
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发表时间：
2000-07-01
影响因子：
2.8
通讯作者：
Cooper, KH
中科院分区：
文献类型：
--
作者：
Gibbons, LW;Mitchell, TL;Cooper, KH
无症状人群的运动试验一直被批评不能准确预测冠心病（CHD）的风险。然而，先前对无症状受试者的研究可能不够大或时间不够长，无法提供可靠的结果测量。本研究探讨了最大运动试验在无症状男性人群中预测冠心病死亡和其他原因死亡的能力。这是一项在1970年至1989年间进行的前瞻性纵向研究，平均随访8.4年。受试者为25,927名健康男性，基线年龄为20至82岁（平均42.9岁），无心血管疾病，在预防医学诊所接受评估。主要结局指标为冠心病死亡率和全因死亡率。在随访期间，有612人死于各种原因，158人死于冠心病。异常运动试验预测冠状动脉死亡的敏感性为61%。无危险因素组运动试验异常导致冠心病死亡的年龄校正相对危险度为21(6.9 ~ 63.3)，有1个危险因素组为27(10.7 ~ 68.8)，有2个危险因素组为54(21.5 ~ 133.7)，有大于等于3个危险因素组为80（30.0 ~ 212.5）。在无心血管疾病的无症状男性中进行的最大运动试验似乎是预测未来冠心病死亡风险的一个有价值的工具。与没有常规危险因素的人相比，异常的运动测试是一个更有力的风险预测指标。(C) 2000年由摘录医学公司。
Exercise testing in asymptomatic persons has been criticized for failing to accurately predict those at risk for coronary heart disease (CHD). Previous studies on asymptomatic subjects, however, may not have been large enough or long enough to provide reliable outcome measures. This study examines the ability of a maximal exercise test to predict death from CHD and death from any cause in a population of asymptomatic men. This is a prospective longitudinal study performed between 1970 and 1989, with an overage follow-up of 8.4 years. The subjects are 25,927 healthy men, 20 to 82 years of age at baseline (mean 42.9 years) who were free of cardiovascular disease and who were evaluated in a preventive medicine clinic. The main outcome measures are CHD mortality and all-cause mortality. During follow-up there were 612 deaths from all causes and 158 deaths from CHD, The sensitivity of an abnormal exercise test to predict coronary death was 61%. The age-adjusted relative risk of on abnormal exercise test for CHD death was 21 (6.9 to 63.3) in those with no risk factors, 27 (10.7 to 68.8) in those with 1 risk factor, 54 (21.5 to 133.7) in those with 2 risk factors, and 80 (30.0 to 212.5) in those with greater than or equal to 3 factors. A maximal exercise test performed in asymptomatic men free of cardiovascular disease does appear to be a worthwhile tool in predicting future risk of CHD death. An abnormal exercise test is a more powerful predictor of risk in those with than without conventional risk factors. (C) 2000 by Excerpta Medica, Inc.