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Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia.
Atherosclerosis. 2004 Apr; 173(2):347-52.A

Abstract

BACKGROUND

Several clinical and observational studies have established that exercise capacity and activity status are strong predictors of cardiovascular and overall mortality. We aimed to evaluate the relationship between exercise tolerance test (ETT) indices and occurrence of coronary heart disease (CHD), in patients with heterozygous Familial Hypercholesterolemia (eFH).

METHODS

During 1987-1997, we enrolled 639 cardiovascular disease-free patients with heterozygous eFH; 58 (9%) patients were excluded since they had a positive ETT. A fatal or non-fatal CHD event was the end point. Cox proportional hazards models were applied to evaluate the association between the investigated outcome and ETT indices.

RESULTS

During the follow-up (1987-2002), 53 (18%) men and 34 (10%) women developed a CHD event (11 were fatal). The age-adjusted event rate was 87 events per 2915 person-years (3%). Statistical analysis revealed that exercise capacity (hazard ratio = 0.82, P < 0.001), heart rate recovery at 1 min (hazard ratio = 0.91, P < 0.05), and peak pulse pressure levels (hazard ratio = 1.03, P < 0.001), were predictors of CHD, after controlling for several potential confounders.

CONCLUSION

Decreased exercise capacity, a delayed decrease in heart rate during the first minute of graded exercise, and increased peak pulse pressure are strong predictors of coronary events in patients with eFH. Physical activity should be strongly recommended in these patients.

Authors+Show Affiliations

First Cardiology Department, School of Medicine, University of Athens, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15064112

Citation

Pitsavos, Christos H., et al. "Exercise Capacity and Heart Rate Recovery as Predictors of Coronary Heart Disease Events, in Patients With Heterozygous Familial Hypercholesterolemia." Atherosclerosis, vol. 173, no. 2, 2004, pp. 347-52.
Pitsavos CH, Chrysohoou C, Panagiotakos DB, et al. Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia. Atherosclerosis. 2004;173(2):347-52.
Pitsavos, C. H., Chrysohoou, C., Panagiotakos, D. B., Kokkinos, P., Skoumas, J., Papaioannou, I., Michaelides, A. P., Singh, S., & Stefanadis, C. I. (2004). Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia. Atherosclerosis, 173(2), 347-52.
Pitsavos CH, et al. Exercise Capacity and Heart Rate Recovery as Predictors of Coronary Heart Disease Events, in Patients With Heterozygous Familial Hypercholesterolemia. Atherosclerosis. 2004;173(2):347-52. PubMed PMID: 15064112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia. AU - Pitsavos,Christos H, AU - Chrysohoou,Christina, AU - Panagiotakos,Demosthenes B, AU - Kokkinos,Peter, AU - Skoumas,John, AU - Papaioannou,Ioanna, AU - Michaelides,Andreas P, AU - Singh,Steven, AU - Stefanadis,Christodoulos I, PY - 2003/09/08/received PY - 2003/11/20/revised PY - 2003/12/18/accepted PY - 2004/4/6/pubmed PY - 2004/10/6/medline PY - 2004/4/6/entrez SP - 347 EP - 52 JF - Atherosclerosis JO - Atherosclerosis VL - 173 IS - 2 N2 - BACKGROUND: Several clinical and observational studies have established that exercise capacity and activity status are strong predictors of cardiovascular and overall mortality. We aimed to evaluate the relationship between exercise tolerance test (ETT) indices and occurrence of coronary heart disease (CHD), in patients with heterozygous Familial Hypercholesterolemia (eFH). METHODS: During 1987-1997, we enrolled 639 cardiovascular disease-free patients with heterozygous eFH; 58 (9%) patients were excluded since they had a positive ETT. A fatal or non-fatal CHD event was the end point. Cox proportional hazards models were applied to evaluate the association between the investigated outcome and ETT indices. RESULTS: During the follow-up (1987-2002), 53 (18%) men and 34 (10%) women developed a CHD event (11 were fatal). The age-adjusted event rate was 87 events per 2915 person-years (3%). Statistical analysis revealed that exercise capacity (hazard ratio = 0.82, P < 0.001), heart rate recovery at 1 min (hazard ratio = 0.91, P < 0.05), and peak pulse pressure levels (hazard ratio = 1.03, P < 0.001), were predictors of CHD, after controlling for several potential confounders. CONCLUSION: Decreased exercise capacity, a delayed decrease in heart rate during the first minute of graded exercise, and increased peak pulse pressure are strong predictors of coronary events in patients with eFH. Physical activity should be strongly recommended in these patients. SN - 0021-9150 UR - https://www.unboundmedicine.com/medline/citation/15064112/Exercise_capacity_and_heart_rate_recovery_as_predictors_of_coronary_heart_disease_events_in_patients_with_heterozygous_Familial_Hypercholesterolemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021915004000243 DB - PRIME DP - Unbound Medicine ER -