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Treadmill Performance & Cardiac Mortality

Treadmill Performance & Cardiac Mortality

Exercise stress tests are commonly used to determine if patients need invasive cardiac testing and to inform treatment decisions. Patients with abnormal electrocardiograms (EKG) findings during exercise or who develop symptoms suggestive of abnormal heart strain during tests are referred for angiography. Those with normal EKG readings and no alarming symptoms during exercise typically do not require further testing. “Stress test results are currently interpreted as ‘either/or’ results, but we know that heart disease is not binary—it’s a continuum of disease,” explains Haitham M. Ahmed, MD, MPH. “Coronary heart disease starts at a young age and continues to progress over decades. It’s a mistake to wait until coronary blockages are severe enough to cause symptoms, a heart attack, or death. Several exercise-based risk scoring systems are already in use, but these often focus on patients with established heart disease or overt signs of cardiovascular trouble. It would be beneficial to find exercise stress test variables that are most helpful for estimating long-term cardiovascular risks earlier in the continuum.”   Quantifying Risk For a study published in Mayo Clinic Proceedings, Dr. Ahmed and colleagues analyzed data from more than 58,000 exercise stress tests to determine which routinely collected variables most strongly correlate with survival. The authors then derived a fitness risk score, dubbed the FIT Treadmill Score, to predict 10-year survival. “We wanted to precisely quantify risk by age, gender, and fitness level, and with a simple equation that required no additional testing beyond the standard stress test,” says Dr. Ahmed. According to the study, fitness level was the single most powerful predictor of death and survival, even after accounting...
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