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We assessed the impact of diabetes mellitus (DM) on the association between exercise capacity and all–cause mortality.
We included 54,098 patients (mean age = 53 years; 50% male; 18% diabetic) free of known coronary heart disease or heart failure completed a maximal exercise test between 1991 and 2008. Patients were divided into 4 groups based on whether they had DM and achieved >6 METs at peak exercise (estimated from exercise protocol used and exercise duration). Patients were followed for 10.1 +/– 4.4 years.
A graded increase in mortality risk was noted with decreased exercise capacity for both diabetics and non–diabetics. In multivariable Cox regression, there was a significant interaction between DM and METs (P < 0.001). In comparison to patients without DM and good exercise capacity (Ex), the adjusted Hazard ratios for death among diabetics with good Ex (HR 1.5, 95% CI 1.4 – 1.7), non–diabetics with poor Ex (HR 3.0, 95% CI 2.7 – 3.3), and diabetics with poor Ex (HR 3.7, 95% CI 3.3–4.2); all p< 0.001
Achievement of an exercise capacity > 6 METs is a stronger independent predictor of all–cause mortality than diabetes.
West, Room 3005
Sunday, March 10, 2013, 8:15 a.m.–8:30 a.m.
Session Title: Exercise and Health: New Insights
Abstract Category: 29. Sports and Exercise Cardiology: Diagnostic Testing: ECG Exercise or “The Older Athlete”
Presentation Number: 921–4
- 2013 American College of Cardiology Foundation