Six-Minute Walk Test as a Prognostic Tool in Stable Coronary Heart Disease: Data From the Heart and Soul Study
Open accessAbstract
BACKGROUND: The prognostic value of the 6-minute walk test (6MWT) in patients with stable coronary heart disease is unknown. We sought to determine whether the 6MWT predicted cardiovascular events in ambulatory patients with coronary heart disease. METHODS: We measured 6MWT distance and treadmill exercise capacity in 556 outpatients with stable coronary heart disease from September 11, 2000, through December 20, 2002. Participants were followed up for a median of 8.0 years for cardiovascular events (heart failure, myocardial infarction, and death). RESULTS: Cardiovascular events occurred in 218 of 556 participants (39.2%). Patients in the lowest quartile of 6MWT distance (87-419 m) had 4 times the rate of events as those in the highest quartile (544-837 m) (unadjusted hazard ratio, 4.29; 95% CI, 2.83-6.53; P < .001). Each SD decrease in 6MWT distance (104 m) was associated with a 55% higher rate of cardiovascular events (age-adjusted hazard ratio, 1.55; 95% CI, 1.35-1.78). After adjustment for traditional risk factors and cardiac disease severity measures (ejection fraction, inducible ischemia, diastolic dysfunction, amino-terminal portion of the prohormone of brain-type natriuretic peptide, and C-reactive protein), each SD decrease in 6MWT was associated with a 30% higher rate of cardiovascular events (hazard ratio, 1.30; 95% CI, 1.10-1.53). When added to traditional risk factors, the 6MWT resulted in category-free net reclassification improvement of 39% (95% CI, 19%-60%). The discriminative ability of the 6MWT was similar to that of treadmill exercise capacity for predicting cardiovascular events (C statistics both 0.72; P = .29). CONCLUSIONS: Distance walked on the 6MWT predicted cardiovascular events in patients with stable coronary heart disease. The addition of a simple 6MWT to traditional risk factors improved risk prediction and was comparable with treadmill exercise capacity.
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Patients with type 2 diabetes have lower exercise capacity than people without type 2 diabetes.
“have lower exercise capacity compared with those without T2DM”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [157]
Lower physical activity and lower exercise capacity are associated with a higher risk of cardiovascular events.
“factors associated with a higher risk of cardiovascular events”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [157]
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- Authors
- Beatty, A. L., Schiller, N. B., & Whooley, M. A.
- Affiliations
- University of California, San Francisco (US)
- San Francisco VA Medical Center (US)
- Corresponding author
- Beatty, Alexis L.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2012-07-23
- Volume
- 172
- Issue
- 14
- Pages
- 1096-102
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC3420342
- OpenAlex
- W2014055624
- Cited by
- 174
- References
- 41
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 14 · 2023: 14 · 2022: 20 · 2021: 12 · 2020: 23 · 2019: 9 · 2018: 11 · 2017: 5 · 2016: 10 · 2015: 10 · 2014: 12 · 2013: 15 · 2012: 3
- FWCI
- 31.17
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (F32HL110518, R01HL079235)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- 6-minute walk test, stable coronary artery disease, cardiovascular events, prognosis, treadmill exercise capacity, risk prediction, heart failure, myocardial infarction, mortality, net reclassification improvement, prognostic factors
- MeSH terms
- Aged, Aged, 80 and over, Coronary Disease, Exercise Test, Female, Forecasting, Heart Failure, Humans, Male, Middle Aged, Mortality, Myocardial Infarction, Predictive Value of Tests, Prognosis, Prospective Studies, San Francisco
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