Combined effects of exercise capacity and coronary atherosclerotic burden on all-cause mortality in asymptomatic Koreans

Su Yeon Choi, Jidong Sung, Hyo Eun Park, Donghee Han, Hyuk Jae Chang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and aims Both exercise capacity and coronary artery calcium score (CACS) are important prognostic factors in cardiovascular outcome. Yet, whether there is a significant interaction between these two factors in influencing clinical outcome is still uncertain. This study investigated the combined effects of exercise capacity and CACS on all-cause mortality in an asymptomatic population. Methods From multicenter registry of health screening, a retrospective cohort of 25,972 asymptomatic subjects, who underwent both CACS and treadmill exercise test, was included in the final dataset for analysis. Outcome was defined as all-cause mortality, which was obtained from national mortality registry. Results The mean age of study subjects was 53.7 ± 7.7 years and 81.5% of them were males. Median follow-up duration was 5.5 (IQR 3.6–7.5) years and 226 (0.9%) cases of all-cause mortality occurred. In multivariate Cox's proportional hazard model with interaction term, exercise capacity ≥10 METs (HR 0.684, 95% CI 0.483–0.971) and CACS ≥400 (HR 3.328, 95% CI 1.850–5.988) were significant predictors of all-cause mortality. In patients with higher exercise capacity, the effect of high CACS on all-cause mortality was significantly smaller than in those with lower exercise capacity. The HR for all-cause mortality of CACS ≥400, in those with lower exercise capacity, is estimated to be about three times of that in those with higher exercise capacity (HR 3.328 in <10 METs vs. 1.108 in ≥10 METs, p for interaction = 0.024) after adjustment for age, gender, fasting glucose, creatinine, alanine transaminase and albumin. Conclusions The effect of high CACS on all-cause mortality is lessened by good exercise capacity in the asymptomatic population. Good physical fitness may reduce the adverse effect of high coronary atherosclerotic burden.

Original languageEnglish
Pages (from-to)396-403
Number of pages8
JournalAtherosclerosis
Volume251
DOIs
Publication statusPublished - 2016 Aug 1

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Coronary Vessels
Exercise
Calcium
Mortality
Exercise Test
Registries
Physical Fitness
Alanine Transaminase
Proportional Hazards Models
Population
Albumins
Fasting
Creatinine
Glucose
Health

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Combined effects of exercise capacity and coronary atherosclerotic burden on all-cause mortality in asymptomatic Koreans",
abstract = "Background and aims Both exercise capacity and coronary artery calcium score (CACS) are important prognostic factors in cardiovascular outcome. Yet, whether there is a significant interaction between these two factors in influencing clinical outcome is still uncertain. This study investigated the combined effects of exercise capacity and CACS on all-cause mortality in an asymptomatic population. Methods From multicenter registry of health screening, a retrospective cohort of 25,972 asymptomatic subjects, who underwent both CACS and treadmill exercise test, was included in the final dataset for analysis. Outcome was defined as all-cause mortality, which was obtained from national mortality registry. Results The mean age of study subjects was 53.7 ± 7.7 years and 81.5{\%} of them were males. Median follow-up duration was 5.5 (IQR 3.6–7.5) years and 226 (0.9{\%}) cases of all-cause mortality occurred. In multivariate Cox's proportional hazard model with interaction term, exercise capacity ≥10 METs (HR 0.684, 95{\%} CI 0.483–0.971) and CACS ≥400 (HR 3.328, 95{\%} CI 1.850–5.988) were significant predictors of all-cause mortality. In patients with higher exercise capacity, the effect of high CACS on all-cause mortality was significantly smaller than in those with lower exercise capacity. The HR for all-cause mortality of CACS ≥400, in those with lower exercise capacity, is estimated to be about three times of that in those with higher exercise capacity (HR 3.328 in <10 METs vs. 1.108 in ≥10 METs, p for interaction = 0.024) after adjustment for age, gender, fasting glucose, creatinine, alanine transaminase and albumin. Conclusions The effect of high CACS on all-cause mortality is lessened by good exercise capacity in the asymptomatic population. Good physical fitness may reduce the adverse effect of high coronary atherosclerotic burden.",
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Combined effects of exercise capacity and coronary atherosclerotic burden on all-cause mortality in asymptomatic Koreans. / Choi, Su Yeon; Sung, Jidong; Park, Hyo Eun; Han, Donghee; Chang, Hyuk Jae.

In: Atherosclerosis, Vol. 251, 01.08.2016, p. 396-403.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Combined effects of exercise capacity and coronary atherosclerotic burden on all-cause mortality in asymptomatic Koreans

AU - Choi, Su Yeon

AU - Sung, Jidong

AU - Park, Hyo Eun

AU - Han, Donghee

AU - Chang, Hyuk Jae

PY - 2016/8/1

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N2 - Background and aims Both exercise capacity and coronary artery calcium score (CACS) are important prognostic factors in cardiovascular outcome. Yet, whether there is a significant interaction between these two factors in influencing clinical outcome is still uncertain. This study investigated the combined effects of exercise capacity and CACS on all-cause mortality in an asymptomatic population. Methods From multicenter registry of health screening, a retrospective cohort of 25,972 asymptomatic subjects, who underwent both CACS and treadmill exercise test, was included in the final dataset for analysis. Outcome was defined as all-cause mortality, which was obtained from national mortality registry. Results The mean age of study subjects was 53.7 ± 7.7 years and 81.5% of them were males. Median follow-up duration was 5.5 (IQR 3.6–7.5) years and 226 (0.9%) cases of all-cause mortality occurred. In multivariate Cox's proportional hazard model with interaction term, exercise capacity ≥10 METs (HR 0.684, 95% CI 0.483–0.971) and CACS ≥400 (HR 3.328, 95% CI 1.850–5.988) were significant predictors of all-cause mortality. In patients with higher exercise capacity, the effect of high CACS on all-cause mortality was significantly smaller than in those with lower exercise capacity. The HR for all-cause mortality of CACS ≥400, in those with lower exercise capacity, is estimated to be about three times of that in those with higher exercise capacity (HR 3.328 in <10 METs vs. 1.108 in ≥10 METs, p for interaction = 0.024) after adjustment for age, gender, fasting glucose, creatinine, alanine transaminase and albumin. Conclusions The effect of high CACS on all-cause mortality is lessened by good exercise capacity in the asymptomatic population. Good physical fitness may reduce the adverse effect of high coronary atherosclerotic burden.

AB - Background and aims Both exercise capacity and coronary artery calcium score (CACS) are important prognostic factors in cardiovascular outcome. Yet, whether there is a significant interaction between these two factors in influencing clinical outcome is still uncertain. This study investigated the combined effects of exercise capacity and CACS on all-cause mortality in an asymptomatic population. Methods From multicenter registry of health screening, a retrospective cohort of 25,972 asymptomatic subjects, who underwent both CACS and treadmill exercise test, was included in the final dataset for analysis. Outcome was defined as all-cause mortality, which was obtained from national mortality registry. Results The mean age of study subjects was 53.7 ± 7.7 years and 81.5% of them were males. Median follow-up duration was 5.5 (IQR 3.6–7.5) years and 226 (0.9%) cases of all-cause mortality occurred. In multivariate Cox's proportional hazard model with interaction term, exercise capacity ≥10 METs (HR 0.684, 95% CI 0.483–0.971) and CACS ≥400 (HR 3.328, 95% CI 1.850–5.988) were significant predictors of all-cause mortality. In patients with higher exercise capacity, the effect of high CACS on all-cause mortality was significantly smaller than in those with lower exercise capacity. The HR for all-cause mortality of CACS ≥400, in those with lower exercise capacity, is estimated to be about three times of that in those with higher exercise capacity (HR 3.328 in <10 METs vs. 1.108 in ≥10 METs, p for interaction = 0.024) after adjustment for age, gender, fasting glucose, creatinine, alanine transaminase and albumin. Conclusions The effect of high CACS on all-cause mortality is lessened by good exercise capacity in the asymptomatic population. Good physical fitness may reduce the adverse effect of high coronary atherosclerotic burden.

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