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Is cardiorespiratory fitness related to cardiometabolic health and all-cause mortality risk in patients with coronary heart disease? A CARE CR study

Nichols, Simon; Taylor, Claire; Page, Richard; Kallvikbacka-Bennett, Anna; Nation, Fiona; Goodman, Toni; Clark, Andrew L.; Carroll, Sean; Ingle, Lee

Authors

Simon Nichols

Claire Taylor

Richard Page

Anna Kallvikbacka-Bennett

Fiona Nation

Toni Goodman

Andrew L. Clark



Abstract

Background: Higher cardiorespiratory fitness (CRF) is associated with lower morbidity and mortality in patients with
coronary heart disease (CHD). The mechanisms for this are not fully understood. A more favourable cardiometabolic
risk factor profile may be responsible; however, few studies have comprehensively evaluated cardiometabolic risk
factors in relation to CRF amongst patients with CHD. We aimed to explore differences in cardiometabolic risk and
5-year all-cause mortality risk in patients with CHD who have low, moderate, and high levels of CRF.
Methods: Patients with CHD underwent maximal cardiopulmonary exercise testing, echocardiogram, carotid
intima-media thickness measurement, spirometry, and dual X-ray absorptiometry assessment. Full blood count,
biochemical lipid profiles, high-sensitivity (hs) C-reactive protein, and NT-proBNP were analysed. Patients were
defined as having low, moderate, or high CRF based on established prognostic thresholds.
Results: Seventy patients with CHD (age 63.1 ± 10.0 years, 86% male) were recruited. Patients with low CRF had a
lower ventilatory anaerobic threshold, peak oxygen pulse, post-exercise heart rate recovery, and poor ventilatory
efficiency. The low CRF group also had higher NT pro-BNP, hs-CRP, non-fasting glucose concentrations, and lower
haemoglobin and haematocrit. Five-year mortality risk (CALIBER risk score) was also greatest in the lowest CRF
group (14.9%).
Conclusions: Practitioners should interpret low CRF as an important clinical risk factor associated with adverse
cardiometabolic health and poor prognosis, study registry; www.researchregistry.com.

Journal Article Type Article
Publication Date 2018-12
Journal Sports Medicine - Open
Print ISSN 2199-1170
Electronic ISSN 2198-9761
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 4
Issue 1
Item Discussed No
APA6 Citation Nichols, S., Taylor, C., Page, R., Kallvikbacka-Bennett, A., Nation, F., Goodman, T., …Ingle, L. (2018). Is cardiorespiratory fitness related to cardiometabolic health and all-cause mortality risk in patients with coronary heart disease? A CARE CR study. Sports Medicine - Open, 4(1), https://doi.org/10.1186/s40798-018-0138-z
DOI https://doi.org/10.1186/s40798-018-0138-z
Keywords Coronary Heart Disease; Cardiac Rehabilitation; Cardiometabolic Health; Exercise Training; Atherosclerosis; VO2peak; Maximal Cardiopulmonary Exercise Testing; CALIBER 5-year risk
Publisher URL https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-018-0138-z
Copyright Statement © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Copyright Statement
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.





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