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Exercise Stress Tests Can Also Predict Noncardiovascular Deaths

Low functional aerobic capacity, abnormal heart rate recovery, and low chronotropic index tied to noncardiovascular death

By Lori Solomon HealthDay Reporter

THURSDAY, Sept. 14, 2023 (HealthDay News) — Abnormalities on an exercise stress test can predict both cardiovascular (CV)- and non-CV-related deaths, according to a study published in the September issue of Mayo Clinic Proceedings.

Nóra Sydó, M.D., Ph.D., from Semmelweis University in Budapest, Hungary, and colleagues sought to identify specific causes of death and determine the prevalence of non-CV deaths in an exercise test referral population and to assess whether exercise test parameters predict non-CV as well as CV deaths. The analysis included nonimaging exercise tests from 13,382 patients (30 to 79 years; September 1993 to December 2010) with mortality determined through January 2016 via Mayo Clinic records and the Minnesota Death Index.

The researchers found that risk for non-CV death was significant for low functional aerobic capacity (hazard ratio, 1.42), abnormal heart rate recovery (hazard ratio, 1.36), and low chronotropic index (hazard ratio, 1.49). An abnormal exercise electrocardiogram (ECG) was not a significant risk. There was a stronger association observed between all exercise test abnormalities, including a composite exercise test score (EX_SCORE), and CV death versus non-CV death, except abnormal exercise ECG.

“Patients should be encouraged to increase physical activity if these prognostic parameters are abnormal, even in the absence of substantial ECG-based CV risk,” the authors write.

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