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Related Experiment Videos

Diagnostic exercise tests on 4000 consecutive men.

M Prakash1, J Myers, V F Froelicher

  • 1Division of Cardiovascular Medicine, Stanford University Medical Center, Palo Alto, Calif., USA.

American Heart Journal
|June 30, 2001
PubMed
Summary
This summary is machine-generated.

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Abnormal treadmill test responses are common in men referred for cardiac evaluation. A simple score combining four variables accurately predicts mortality risk, aiding clinical decisions.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Clinical Exercise Physiology

Background:

  • Exercise treadmill testing is a common diagnostic tool for cardiac disease.
  • Limited data exists on abnormal test response prevalence and mortality association in large, consecutive patient cohorts.
  • Standardized testing protocols are crucial for reliable diagnostic interpretation.

Purpose of the Study:

  • To determine the prevalence of abnormal exercise treadmill test responses.
  • To assess the association between these abnormal responses and all-cause mortality.
  • To identify predictors of mortality in patients undergoing diagnostic exercise testing.

Main Methods:

  • Analysis of 3974 men undergoing treadmill tests between 1987-2000 at Veterans Affairs Medical Centers.

Related Experiment Videos

  • Exclusion of patients with pre-existing heart conditions.
  • Follow-up for mortality using the Social Security Death Index (mean 5.9 years).
  • Standard survival analysis including Kaplan-Meier curves and Cox hazard models.

    • Main Results:

    • Annual mortality rate of 1.8% in the study population.
    • Key predictors of mortality identified: reduced rate pressure product, age >65, METs <5, and left ventricular hypertrophy.
    • A risk score based on these factors stratified patients into distinct mortality risk groups.
    • High-risk individuals (score >3) showed a 4-fold increased hazard ratio for mortality.

    Conclusions:

    • Provides expected rates of abnormal exercise treadmill test responses in a male veteran population.
    • A simple, four-variable score effectively predicts all-cause mortality.
    • This score can assist clinicians in risk stratification and therapeutic decision-making.