Combined effect of cardiorespiratory fitness and adiposity on mortality in patients with coronary artery disease

High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Coronary artery disease patients (n =...

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Vydáno v:The American heart journal Ročník 161; číslo 3; s. 590 - 597
Hlavní autoři: Goel, Kashish, Thomas, Randal J., Squires, Ray W., Coutinho, Thais, Trejo-Gutierrez, Jorge F., Somers, Virend K., Miles, John M., Lopez-Jimenez, Francisco
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York, NY Elsevier Inc 01.03.2011
Mosby
Elsevier Limited
Témata:
Adiposity - physiology
Aged
Biological and medical sciences
Body Mass Index
Cardiology. Vascular system
Cardiovascular
Coronary Artery Disease - mortality
Coronary heart disease
Coronary vessels
Exercise Test
Female
Heart
Heart attacks
Humans
Male
Medical sciences
Middle Aged
Mortality
Obesity
Obesity - epidemiology
Oxygen Consumption
Physical Fitness
Proportional Hazards Models
Human
Prognosis
Mortality
Patient
Cardiovascular disease
Circulatory system
Cardiology
Coronary heart disease
Fitness
ISSN:0002-8703, 1097-6744, 1097-6744
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Shrnutí:High cardiorespiratory fitness and body mass index (BMI) are associated with decreased mortality in patients with coronary artery disease. Our objective was to determine the joint impact of fitness and adiposity measures on all-cause mortality in this subgroup. Coronary artery disease patients (n = 855) enrolled in the Mayo Clinic cardiac rehabilitation program from 1993 to 2007 were included. Fitness levels were determined by cardiopulmonary exercise testing. Patients were divided into low and high fitness by sex-specific median values of peak oxygen consumption and total treadmill time. Adiposity was measured through BMI and waist-to-hip ratio (WHR). There were 159 deaths during 9.7 ± 3.6 years of mean follow-up. After adjusting for potential confounding factors, low fitness, shorter treadmill time, low BMI, and high WHR were significantly associated with increased mortality. Using low WHR–high fitness group as reference, significantly increased mortality was noted in low WHR–low fitness (hazard ratio 4.2, 95% CI, 1.8-9.8), centrally obese–high fitness (2.3, 1.0-5.4), and centrally obese–low fitness (6.1, 2.7-13.6) groups. Overweight–high fitness (2.2, 0.63-7.4), obese–high fitness (3.2, 0.88-11.4), and obese–low fitness (3.3, 0.96-11.4) subjects did not have a significantly different mortality as compared with the reference group of normal weight–high fitness subjects, whereas normal weight–low fitness (9.6, 2.9-31.8) and overweight–low fitness (6.8, 2.1-22.2) groups had significantly increased mortality. Low fitness and central obesity were independently and cumulatively associated with increased mortality in coronary artery disease patients attending cardiac rehabilitation. The association of BMI with mortality is complex and altered by fitness levels.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0002-8703
1097-6744
1097-6744
DOI:10.1016/j.ahj.2010.12.012