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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


Simon Nichols

Claire Taylor

Richard Page

Anna Kallvikbacka-Bennett

Fiona Nation

Toni Goodman

Andrew L. Clark


© 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;


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),

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
Keywords Coronary Heart Disease; Cardiac Rehabilitation; Cardiometabolic Health; Exercise Training; Atherosclerosis; VO2peak; Maximal Cardiopulmonary Exercise Testing; CALIBER 5-year risk
Public URL
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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 (, 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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