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Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation
Open accessAbstract
Objectives This study investigated the prognostic importance of measured peak oxygen intake (VO(2peak)) in women with known coronary heart disease referred for outpatient cardiac rehabilitation.Background Exercise capacity is a powerful predictor of prognosis in men with known or suspected coronary disease. Similar findings are described in women, but fewer studies have utilized measured VO(2peak), the most accurate measure of exercise capacity.Methods A single-center design took data from 2,380 women, age 59.7 +/- 9.5 years (1,052 myocardial infarctions, 620 coronary bypass procedures, and 708 with proven ischemic heart disease), who underwent cardiorespiratory exercise testing. They were followed for an average of 6.1 +/- 5 years (median 4.5 years, range 0.4 to 25 years) until cardiac and all-cause death.Results We recorded 95 cardiac deaths and 209 all-cause deaths. Measured VO(2peak) was an independent predictor of risk, values > or =13 ml/kg/min (3.7 multiples of resting metabolic rate) conferring a 50% reduction in cardiac mortality (hazard ratio [HR] 0.5, p = 0.001). Considered as a continuous variable, a 1 ml/kg/min advantage in initial VO(2peak) was associated with a 10% lower cardiac mortality. Adverse predictors were diabetes (HR 2.73, p = 0.0005) and antiarrhythmic therapy (HR 3.93, p = 0.0001).Conclusions As in men, measured VO(2peak) is a strong independent predictor of cardiac mortality in women referred for cardiac rehabilitation.
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“Numerous studies now suggest that CRF is one of the strongest prognostic markers in persons with and without chronic disease, including CVD [13] , [14] , [15] , [16] .”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [15]
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“recent data confirm the existence of an inverse dose-response relationship between cardiovascular fitness (evaluated by treadmill stress testing and expressed in METs) and all-cause mortality in large populations of both male and female cardiovascular patients”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [335]
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Metadata
- Authors
- Kavanagh, T., Mertens, D. J., Hamm, L. F., Beyene, J., Kennedy, J., Corey, P., & Shephard, R. J.
- Affiliations
- University of Toronto (CA)
- Toronto Rehabilitation Institute (CA)
- George Washington University (US)
- Corresponding author
- Kavanagh, Terence
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2003-12
- Volume
- 42
- Issue
- 12
- Pages
- 2139-2143
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2119705713
- Cited by
- 380
- References
- 22
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 12 · 2023: 15 · 2022: 19 · 2021: 18 · 2020: 22 · 2019: 26 · 2018: 14 · 2017: 17 · 2016: 21 · 2015: 17 · 2014: 19 · 2013: 21 · 2012: 28
- FWCI
- 22.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- exercise capacity, cardiac mortality, women, coronary artery disease, cardiac rehabilitation, prognosis, all-cause mortality, diabetes mellitus, antiarrhythmic therapy, myocardial infarction, coronary artery bypass grafting
- MeSH terms
- Coronary Artery Bypass, Coronary Disease, Exercise Test, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Oxygen Consumption, Prognosis
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