scholarly journals Predictive Validity of a Medical-Related Cardiorespiratory Fitness Algorithm in Predicting Cardiovascular Disease– and All-Cause Mortality: Implications for Integration Into Clinical Practice

2016 ◽  
Vol 91 (9) ◽  
pp. 1320-1321 ◽  
Author(s):  
Ovuokerie Addoh ◽  
Meghan K. Edwards ◽  
Paul D. Loprinzi
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Predictive Validity ◽  
Cardiorespiratory Fitness ◽  
All Cause Mortality

A history of smoking does not reduce long-term benefits of cardiac rehabilitation on cardiorespiratory fitness in men and women with cardiovascular disease

2020 ◽  
Author(s):  
Kenneth Shinkichi Noguchi ◽  
Michael Pryzbek ◽  
Kevin Moncion ◽  
Angelica McQuarrie ◽  
Maureen J. MacDonald ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiac Rehabilitation ◽  
Cardiorespiratory Fitness ◽  
Smoking Behaviour ◽  
Smoking History ◽  
Cardiac Events ◽  
Men And Women ◽  
All Cause Mortality ◽  
History Of

Smoking is an important risk factor for cardiovascular disease and all-cause mortality. Cardiac rehabilitation (CR) is effective for reducing the risk of recurrent cardiac events through improving cardiorespiratory fitness (CRF). Little is known about the influence of smoking on CRF throughout long-term CR. The purpose of this analysis was to compare CRF trajectories among individuals with positive and negative smoking history enrolled in long-term CR. Participants had a positive smoking history if they currently smoke or formerly smoked (Smoke+, n=55, mean age=64.9 ± 9.0 years) and had a negative history if they never smoked (Smoke–, n=34, mean age=61.4 ± 9.0 years). CRF (VO2peak) was measured at baseline and annually thereafter for 6 years. The Smoke+ group had lower CRF compared to the Smoke– group over enrollment (β=-3.29 (SE=1.40), 95% CI -6.04, -0.54, p=0.02), but there was no interaction of smoking history and enrollment (β=0.35 (SE=0.21), 95% CI -0.06, 0.77, p=0.10). Moreover, trajectories were not influenced by pack-years (β=0.01 (SE=0.01), 95% CI -0.01, 0.04, p=0.23) or time smoke-free (β=-0.002 (SE=0.01), 95% CI -0.02, 0.02, p=0.80). Although the trajectories of CRF do not appear to be affected by smoking behaviour, individuals without a history of smoking maintained higher CRF throughout enrollment. Novelty bullets: • The benefits of long-term exercise-based cardiac rehabilitation on cardiorespiratory fitness are similar between those who have smoked and those who have never smoked. • Neither the number of pack-years nor the length of time spent smoke-free influence cardiorespiratory fitness trajectories following long-term cardiac rehabilitation.

scholarly journals Cardiovascular Disease and All-Cause Mortality in Male Twins With Discordant Cardiorespiratory Fitness: A Nationwide Cohort Study

2020 ◽  
Vol 189 (10) ◽  
pp. 1114-1123
Author(s):  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Confidence Interval ◽  
Cardiorespiratory Fitness ◽  
Military Service ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Familial Factors ◽  
All Cause Mortality

Abstract Whether genetic and familial factors influence the association between cardiorespiratory fitness (CRF) and cardiovascular disease (CVD) is unknown. Two cohorts were formed based on data from 1,212,295 men aged 18 years who were conscripted for military service in Sweden during 1972–1996. The first comprised 4,260 twin pairs in which the twins in each pair had different CRF (≥1 watt). The second comprised 90,331 nonsibling pairs with different CRF and matched on birth year and year of conscription. Incident CVD and all-cause mortality were identified using national registers. During follow-up (median 32 years), there was no difference in CVD and mortality between fitter twins and less fit twins (246 vs. 251 events; hazard ratio (HR) = 1.00, 95% confidence interval (CI): 0.83, 1.20). The risks were similar in twin pairs with ≥60-watt difference in CRF (HR = 0.96, 95% CI: 0.57, 1.64). In contrast, in the nonsibling cohort, fitter men had a lower risk of the outcomes than less fit men (4,444 vs. 5,298 events; HR = 0.83, 95% CI: 0.79, 0.86). The association was stronger in pairs with ≥60-watt difference in CRF (HR = 0.65, 95% CI: 0.59, 0.71). These findings indicate that genetic and familial factors influence the association of CRF with CVD and mortality.

scholarly journals Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality

2016 ◽  
Vol 42 (4) ◽  
pp. 291-298 ◽  
Author(s):  
Andreas Holtermann ◽  
Jacob Louis Marott ◽  
Finn Gyntelberg ◽  
Karen Søgaard ◽  
Ole Steen Mortensen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Cardiorespiratory Fitness ◽  
Occupational Physical Activity ◽  
All Cause Mortality

scholarly journals External applicability of SGLT2 inhibitor cardiovascular outcome trials to patients with type 2 diabetes and cardiovascular disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Lisanne C. A. Smidt ◽  
Frank L. J. Visseren ◽  
Wendela L. de Ranitz-Greven ◽  
Hendrik M. Nathoe ◽  
L. Jaap Kappelle ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Daily Clinical Practice ◽  
Cardiovascular Outcome ◽  
Exclusion Criteria ◽  
Cardiovascular Outcome Trials ◽  
All Cause Mortality ◽  
Diabetes Patients

Abstract Background Recent treatment guidelines support the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with type 2 diabetes and cardiovascular disease based on the results of cardiovascular outcome trials (CVOTs). Applicability of these trials to everyday patients with type 2 diabetes and cardiovascular disease is however unknown. The aim of this study is to assess the external applicability of SGLT2i CVOTs in daily clinical practice type 2 diabetes patients with established cardiovascular disease. Methods Trial in- and exclusion criteria from EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58 and VERTIS-CV were applied to 1389 type 2 diabetes patients with cardiovascular disease in the Utrecht Cardiovascular Cohort-Secondary Manifestations of ARTerial disease (UCC-SMART). To evaluate the difference in cardiovascular risk (MACE) and all-cause mortality between trial eligible and ineligible patients, age and sex-adjusted Cox-regression analyses were performed. Results After applying trial in- and exclusion criteria, 48% of UCC-SMART patients with type 2 diabetes and cardiovascular disease would have been eligible for DECLARE-TIMI 58, 35% for CANVAS, 29% for EMPA-REG OUTCOME and 21% for VERTIS-CV. Without the eligibility criteria of HbA1c, eligibility was 58–88%. For all trials the observed risk for cardiovascular events and all-cause mortality was similar in eligible and ineligible patients after adjustment for age and gender. Conclusion A large proportion of patients with type 2 diabetes and cardiovascular disease in daily clinical practice would have been eligible for participation in the SGLT2i CVOTs. Trial eligible and ineligible patients have the same risk for MACE and all-cause mortality.

Abstract P378: Higher Non-exercise Estimated Cardiorespiratory Fitness in Midlife is Associated With Lower Risk of Cardiovascular Disease and Mortality in Later Life: The Framingham Heart Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Joowon Lee ◽  
Ramachandran S Vasan ◽  
Vanessa Xanthakis
Keyword(s):  
Cardiovascular Disease ◽  
Cardiorespiratory Fitness ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Health Indicators ◽  
Later Life ◽  
Cox Proportional Hazards ◽  
All Cause Mortality

Introduction: Studies have demonstrated that higher cardiorespiratory fitness (CRF) is associated with a lower risk of cardiovascular disease (CVD) and mortality. However, exercise CRF test is not routinely performed in clinical settings because it requires specialized equipment and trained personnel. Therefore, non-exercise estimated CRF (eCRF) using easily accessible health indicators in clinical practice may be a time- and cost-effective alternative for evaluating fitness. Hypothesis: We hypothesized that higher eCRF in midlife will be associated with a lower risk of CVD and all-cause mortality in later life. Methods: We evaluated 2,501 Framingham Offspring cohort participants (mean age 65 yrs., 52% women). We used a longitudinal non-exercise algorithm that includes age, sex, body mass index, waist circumference, resting heart rate, physical activity, and smoking status. We then used SAS PROC TRAJ to identify sex-specific latent patterns of eCRF (low, moderate, and high eCRF categories) between exam 2 and 8 (1979-2008). Multivariable Cox proportional hazards regression models were used to relate the long-term trajectories of eCRF to incident CVD and all-cause mortality on follow-up. Results: We identified three distinct trajectories of eCRF (Low [n=268, 10.7%] vs. moderate [n=1,273, 50.9%] vs. high [n=960, 38.4%]). Overall, 265 participants developed CVD and 429 died during 10 years of median follow-up. Participants in the “high eCRF” group were at lower risk of CVD and all-cause mortality compared to those in the “low eCRF” group, after adjustment for potential confounders ( Table ). Conclusions: Our findings suggest that lower eCRF during midlife may be a marker of risk of CVD and mortality in older adulthood.

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