Document Detail


Six-minute walk test as a prognostic tool in stable coronary heart disease: data from the heart and soul study.
MedLine Citation:
PMID:  22710902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prognostic value of the 6-minute walk test (6MWT) in patients with stable coronary heart disease is unknown. We sought to determine whether the 6MWT predicted cardiovascular events in ambulatory patients with coronary heart disease.
METHODS: We measured 6MWT distance and treadmill exercise capacity in 556 outpatients with stable coronary heart disease from September 11, 2000, through December 20, 2002. Participants were followed up for a median of 8.0 years for cardiovascular events (heart failure, myocardial infarction, and death).
RESULTS: Cardiovascular events occurred in 218 of 556 participants (39.2%). Patients in the lowest quartile of 6MWT distance (87-419 m) had 4 times the rate of events as those in the highest quartile (544-837 m) (unadjusted hazard ratio, 4.29; 95% CI, 2.83-6.53; P < .001). Each SD decrease in 6MWT distance (104 m) was associated with a 55% higher rate of cardiovascular events (age-adjusted hazard ratio, 1.55; 95% CI, 1.35-1.78). After adjustment for traditional risk factors and cardiac disease severity measures (ejection fraction, inducible ischemia, diastolic dysfunction, amino-terminal portion of the prohormone of brain-type natriuretic peptide, and C-reactive protein), each SD decrease in 6MWT was associated with a 30% higher rate of cardiovascular events (hazard ratio, 1.30; 95% CI, 1.10-1.53). When added to traditional risk factors, the 6MWT resulted in category-free net reclassification improvement of 39% (95% CI, 19%-60%). The discriminative ability of the 6MWT was similar to that of treadmill exercise capacity for predicting cardiovascular events (C statistics both 0.72; P = .29).
CONCLUSIONS: Distance walked on the 6MWT predicted cardiovascular events in patients with stable coronary heart disease. The addition of a simple 6MWT to traditional risk factors improved risk prediction and was comparable with treadmill exercise capacity.
Authors:
Alexis L Beatty; Nelson B Schiller; Mary A Whooley
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  172     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-10-11     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1096-102     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of California, San Francisco, CA 94143, USA. alexis.beatty@ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Coronary Disease / complications*,  diagnosis,  mortality
Exercise Test*
Female
Forecasting
Heart Failure / epidemiology*
Humans
Male
Middle Aged
Mortality*
Myocardial Infarction / mortality*
Predictive Value of Tests
Prognosis
Prospective Studies
San Francisco / epidemiology
Grant Support
ID/Acronym/Agency:
F32 HL110518/HL/NHLBI NIH HHS; F32 HL110518/HL/NHLBI NIH HHS; R01 HL079235/HL/NHLBI NIH HHS; R01 HL079235/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2012 Aug;9(8):432   [PMID:  22776984 ]
JAMA Intern Med. 2013 Jan 28;173(2):168-9   [PMID:  23358842 ]
JAMA Intern Med. 2013 Jan 28;173(2):169   [PMID:  23358843 ]
Arch Intern Med. 2012 Jul 23;172(14):1102-3   [PMID:  22710968 ]

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