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

Abstract

© 2018, The Author(s). 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 ± 10.0years, 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.

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

• Journal Article Type: Article
• Acceptance Date: May 14, 2018
• Online Publication Date: May 30, 2018
• Publication Date: 2018-12
• Deposit Date: May 31, 2018
• Publicly Available Date: May 31, 2018
• 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
• 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
• Public URL: https://hull-repository.worktribe.com/output/856949
• Publisher URL: https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-018-0138-z