Copyright © 2004 by the European Society of Cardiology.
Clinical research
Exercise testing of healthy men in a new perspective: from diagnosis to prognosis
a Department of Cardiology, Rikshospitalet, Sognsvannsveien 20, University of Oslo, 0027 Oslo, Norway
b Department of Epidemiology, Akershus University Hospital, 1474 Nordbyhagen, Norway
c Department of Informatics, University of Oslo, Norway
* Corresponding author. Tel.: +47-23-07-00-00; fax: +47-23-07-39-17
E-mail address: k-eriks{at}online.no
Received 20 November 2003; revised 20 November 2003; accepted 9 April 2004
Abstract
Aim It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters.
Methods and results In 1972–75, 2014 apparently healthy men aged 40–60 had a symptom limited exercise test during a cardiovascular survey. Three hundred died from CHD during 26 years of follow-up. Compared to Cox regression models solely including classical risk factors (CRF), models also including multiple exercise test parameters (CRF+X) were clearly superior (
). Risk scores were computed based on the models. CRF and CRF+X risk scores often differed markedly; CRF+X scores were generally most reliable in both the high and low risk range. In smokers with cholesterol >6.5 mmol/l (
), the CRF and CRF+X models identified 67 vs. 110 men at the highest CHD risk level according to European guidelines (34.2% vs. 38.2% CHD mortality). Three in five CRF+X-identified smokers with cholesterol >6.5 mmol/l had CHD mortality similar to the mean of all 2014 men.
Conclusion Integration of multiple exercise test parameters and conventional risk factors improved CHD risk assessment substantially – especially in smokers with high cholesterol.
Key Words: Exercise testing • Coronary heart disease mortality • Prediction • Healthy men • Follow-up studies
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Kodama, K. Saito, S. Tanaka, M. Maki, Y. Yachi, M. Asumi, A. Sugawara, K. Totsuka, H. Shimano, Y. Ohashi, et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women: A Meta-analysis JAMA, May 20, 2009; 301(19): 2024 - 2035. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Laukkanen, T. H. Makikallio, R. Rauramaa, and S. Kurl Asymptomatic ST-segment depression during exercise testing and the risk of sudden cardiac death in middle-aged men: a population-based follow-up study Eur. Heart J., March 1, 2009; 30(5): 558 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Arena, J. Myers, M. A. Williams, M. Gulati, P. Kligfield, G. J. Balady, E. Collins, and G. Fletcher Assessment of Functional Capacity in Clinical and Research Settings: A Scientific Statement From the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing Circulation, July 17, 2007; 116(3): 329 - 343. [Full Text] [PDF]
|
|
|
|
|
|
M. Lauer, E. S. Froelicher, M. Williams, and P. Kligfield Exercise Testing in Asymptomatic Adults: A Statement for Professionals From the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention Circulation, August 2, 2005; 112(5): 771 - 776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. F. Froelicher Screening with the exercise test: time for a guideline change? Eur. Heart J., July 2, 2005; 26(14): 1353 - 1354. [Full Text] [PDF]
|
|
|
|
|
|
J. Bodegard, G. Erikssen, J. V. Bjornholt, K. Gjesdal, K. Liestol, and J. Erikssen Reasons for terminating an exercise test provide independent prognostic information: 2014 apparently healthy men followed for 26 years Eur. Heart J., July 2, 2005; 26(14): 1394 - 1401. [Abstract] [Full Text] [PDF]
|
|