Journal article
Relation of Heart Rate Response to Exercise With Prognosis and Atherosclerotic Progression After Coronary Artery Bypass Grafting
The American journal of cardiology, Vol.103(10), pp.1386-1390
2009
DOI: 10.1016/j.amjcard.2009.01.346
PMID: 19427433
Abstract
Impaired heart rate response to exercise is associated with adverse clinical outcomes in healthy adults and those with established coronary artery disease. It is unclear whether this association persists in subjects who have undergone coronary artery bypass grafting (CABG). In this study, 920 subjects enrolled in the Post CABG trial who had undergone CABG with patent saphenous vein grafts at baseline and known to have discontinued β blockers before exercise were studied. A maximal symptom-limited exercise treadmill test was performed on study entry. Chronotropic variables were measured at peak exercise. Participants were followed for a composite end point of death, myocardial infarction, stroke, or revascularization. Quantitative coronary angiography was performed at follow-up and compared with baseline angiography, with prespecified angiographic end points of the substantial progression of graft disease and complete occlusion. In multivariate analysis, a low chronotropic index was strongly associated with an increased risk for the composite clinical end point (p for trend = 0.04) and angiographic complete occlusion (p for trend = 0.007) but only weakly associated with angiographic substantial progression (p for trend = 0.07). In conclusion, impaired chronotropic response to exercise identifies subjects at risk for clinical outcomes and graft occlusion, even after revascularization with CABG.
Details
- Title: Subtitle
- Relation of Heart Rate Response to Exercise With Prognosis and Atherosclerotic Progression After Coronary Artery Bypass Grafting
- Creators
- Saket Girotra - Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, IowaMichael Keelan - Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WisconsinAmy R Weinstein - Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MassachusettsMurray A Mittleman - Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MassachusettsKenneth J Mukamal - Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.103(10), pp.1386-1390
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjcard.2009.01.346
- PMID
- 19427433
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 2009
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094760502771
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