Association of demographic, medication, resting vital sign and ECG variables, clinical diagnoses and arm exercise responses with all-cause and cardiovascular mortality over 5 and 12 years
Variable | Arm exercise stress test (N=443) | |||||
---|---|---|---|---|---|---|
5-year | 12-year | |||||
Survivors (n=323, 72.9%) | All-cause mortality (n=120, 27.1%) | CV mortality (n=50, 11.3%) | Survivors (n=187, 42.2%) | All-cause mortality (n=256, 57.8%) | CV mortality (n=102, 23.0%) | |
Demographics | ||||||
Age (years) (SD) | 62.4 (10.6) | 68.6 (10.9) p<0.001 | 68.3 (10.6) p<0.001 | 59.7 (9.9) | 67.3 (10.7) p<0.001 | 65.9 (11.6) p<0.001 |
Height (inches) (SD) | 69.7 (2.9) | 69.4 (4.0) p=0.36 | 68.5 (5.2) p=0.01 | 69.9 (2.7) | 69.4 (3.6) p=0.17 | 69.1 (4.4) p=0.08 |
Weight (lbs) (SD) | 218.1 (54.4) | 196.3 (52.3) p<0.001 | 191.8 (44.9) p=0.001 | 223.2 (53.0) | 204.2 (54.6) p<0.001 | 205.6 (60.3) p=0.01 |
Body mass index (kg/m2) (SD) | 31.5 (7.1) | 28.7 (7.5) p<0.001 | 29.1 (8.3) p=0.03 | 32.1 (7.1) | 29.7 (7.3) p<0.001 | 30.3 (8.6) p=0.06 |
Race (black) (%) | 79 (24.8) | 33 (27.7) p=0.54 | 10 (20.4) p=0.50 | 48 (26.2) | 64 (25.2) p=0.81 | 24 (24) p=0.68 |
Gender (women) (%) | 8 (2.5) | 1 (0.8) p=0.28 | 1 (2.0) p=0.84 | 5 (2.7) | 4 (1.6) p=0.41 | 3 (2.9) p=0.89 |
Medications | ||||||
β-blocker (%) | 125 (38.7) | 55 (45.8) p=0.17 | 30 (60.0) p=0.005 | 75 (40.1) | 105 (41.0) p=0.85 | 47 (46.1) p=0.33 |
ACEI/ARB/hydralazine (%) | 168 (52.0) | 66 (55.0) p=0.58 | 31 (62.0) p=0.19 | 91 (48.7) | 143 (55.9) p=0.13 | 63 (61.8) p=0.03 |
Statin (%) | 124 (38.4) | 40 (33.3) p=0.33 | 18 (36.0) p=0.75 | 74 (39.6) | 90 (35.2) p=0.34 | 36 (35.3) p=0.47 |
Platelet antagonist (%) | 190 (58.8) | 63 (52.5) p=0.23 | 28 (56.0) p=0.71 | 100 (53.5) | 153 (59.8) p=0.19 | 60 (58.8) p=0.38 |
Aldosterone blocker (%) | 13 (4.0) | 4 (3.3) p=0.74 | 0 (0.0) p=0.15 | 6 (3.2) | 11 (4.3) p=0.56 | 1 (1.0) p=0.24 |
Resting vital signs | ||||||
Heart rate (bpm) (SD) | 74 (14) | 78 (16) p=0.01 | 77 (17) p=0.13 | 74 (14) | 76 (16) p=0.20 | 75 (15) p=0.55 |
Systolic BP (mm Hg) (SD) | 136 (21) | 132 (23) p=0.07 | 132 (22) p=0.23 | 135 (20) | 135 (22) p=0.80 | 135 (23) p=0.97 |
Diastolic BP (mm Hg) (SD) | 83 (12) | 78 (12) p<0.001 | 79 (13) p=0.03 | 84 (12) | 80 (13) p<0.001 | 80 (13) p=0.01 |
Resting ECG results | ||||||
Abnormal (%) | 122 (37.8) | 60 (50.0) p=0.02 | 27 (54.0) p=0.03 | 60 (32.1) | 122 (47.7) p=0.001 | 48 (47.1) p=0.01 |
Clinical diagnoses | ||||||
Hypertension (%) | 243 (75.2) | 96 (80.0) p=0.29 | 39 (78.0) p=0.67 | 141 (75.4) | 198 (77.3) p=0.63 | 80 (78.4) p=0.56 |
Dyslipidaemia (%) | 147 (45.5) | 46 (38.3) p=0.18 | 21 (42.0) p=0.64 | 93 (49.7) | 100 (39.1) p=0.03 | 42 (41.2) p=0.16 |
Current smoker (%) | 100 (31.0) | 44 (36.7) p=0.25 | 20 (40.0) p=0.20 | 54 (28.9) | 90 (35.2) p=0.16 | 39 (38.2) p=0.10 |
Past smoker (%) | 120 (37.2) | 43 (35.8) p=0.80 | 17 (34.0) p=0.67 | 69 (36.9) | 94 (36.7) p=0.97 | 33 (32.4) p=0.44 |
Diabetes (%) | 111 (34.4) | 50 (41.7) p=0.16 | 20 (40.0) p=0.44 | 58 (31.0) | 103 (40.3) p=0.05 | 39 (38.2) p=0.21 |
CAD (%) | 126 (39.0) | 56 (46.7) p=0.15 | 29 (58.0) p=0.01 | 69 (36.9) | 113 (44.1) p=0.13 | 51 (50.0) p=0.03 |
History of MI (%) | 87 (26.9) | 50 (41.7) p=0.003 | 23 (46.0) p=0.006 | 49 (26.2) | 88 (34.4) p=0.07 | 33 (32.4) p=0.27 |
History of CHF (%) | 29 (9.0) | 28 (23.3) p<0.001 | 17 (34.0) p<0.001 | 11 (5.9) | 46 (18.0) p<0.001 | 24 (23.5) p<0.001 |
Status post CABG (%) | 53 (16.4) | 29 (24.2) p=0.06 | 17 (34.0) p=0.003 | 27 (14.4) | 55 (21.5) p=0.06 | 29 (28.4) p=0.004 |
Status post PCI (%) | 43 (13.3) | 16 (13.3) p=1.00 | 11 (22.0) p=0.10 | 24 (12.8) | 35 (13.7) p=0.80 | 20 (19.6) p=0.13 |
Atrial fibrillation (%) | 15 (4.5) | 27 (22.5) p<0.001 | 14 (28.0) p<0.001 | 8 (4.3) | 34 (13.3) p=0.001 | 16 (15.7) p<0.001 |
PAD (%) | 75 (23.2) | 55 (45.8) p<0.001 | 27 (54.0) p<0.001 | 33 (17.7) | 97 (37.9) p<0.001 | 44 (43.1) p<0.001 |
COPD (%) | 54 (16.7) | 48 (40.0) p<0.001 | 20 (40.0) p<0.001 | 25 (13.4) | 77 (30.1) p<0.001 | 30 (29.4) p<0.001 |
Renal disease (%) | 19 (5.9) | 18 (15.0) p=0.002 | 8 (16.0) p=0.01 | 9 (4.8) | 28 (10.9) p=0.02 | 10 (9.8) p=0.10 |
Cancer (%) | 20 (6.2) | 26 (21.7) p<0.001 | 7 (14.0) p=0.04 | 5 (2.7) | 41 (16.0) p<0.001 | 10 (9.8) p=0.009 |
Arm exercises responses | ||||||
Peak values | ||||||
Heart rate (bpm) (SD) | 125 (21) | 117 (25) p<0.001 | 115 (26) p=0.002 | 129 (20) | 119 (23) p<0.001 | 117 (22) p<0.001 |
Systolic BP (mm Hg) (SD) | 172 (28) | 161 (33) p<0.001 | 164 (34) p=0.08 | 172 (28) | 166 (31) p=0.05 | 168 (31) p=0.29 |
Diastolic BP (mm Hg) (SD) | 94 (15) | 90 (17) p=0.01 | 91 (17) p=0.28 | 95 (15) | 91 (16) p=0.02 | 92 (16) p=0.24 |
δ Values (Peak–Rest) | ||||||
Heart rate (bpm) (SD) | 52 (19) | 39 (20) p<0.001 | 38 (19) p<0.001 | 56 (19) | 43 (20) p<0.001 | 42 (18) p<0.001 |
Systolic BP (mm Hg) (SD) | 36 (24) | 29 (23) p=0.008 | 32 (20) p=0.31 | 37 (23) | 32 (24) p=0.03 | 34 (22) p=0.22 |
Diastolic BP (mm Hg) (SD) | 11 (12) | 12 (12) p=0.64 | 13 (11) p=0.54 | 11 (14) | 12 (11) p=0.45 | 13 (12) p=0.38 |
Heart rate recovery (bpm) | ||||||
1 min post (SD) | 19 (10) | 11 (8) p<0.001 | 10 (7) p<0.001 | 20 (9) | 14 (9) p<0.001 | 14 (9) p<0.001 |
Exercise capacity (METs) | 3.3 (0.9) | 2.6 (0.8) p<0.001 | 2.6 (0.8) p<0.001 | 3.5 (0.9) | 2.8 (0.9) p<0.001 | 2.8 (0.9) p<0.001 |
Angina | ||||||
Limiting (%) | 7 (2) | 2 (2) p=0.74 | 2 (4) p=0.43 | 3 (2) | 6 (2) p=0.59 | 2 (2) p=0.82 |
Non-limiting (%) | 17 (6) | 11 (10) p=0.25 | 8 (16) p=0.03 | 9 (5) | 19 (8) p=0.59 | 11 (11) p=0.17 |
ST depression ≥1 mm (%) | 39 (13) | 23 (20) p=0.05 | 12 (26) p=0.02 | 19 (10) | 43 (18) p=0.03 | 21 (21) p=0.01 |
Ventricular dysrhythmias (%) | 26 (8) | 17 (14) p=0.05 | 11 (22) p=0.002 | 8 (4) | 35 (14) p=0.001 | 16 (16) p<0.001 |
Data shown are means (SD) or n (%).
Statistically significant differences are designated in bold.
ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BP, blood pressure; CABG, coronary artery bypass grafting; CAD, coronary artery disease; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CV, cardiovascular; METs, resting metabolic equivalents; MI, myocardial infarction; PAD, peripheral arterial disease; PCI, percutaneous coronary intervention.