Pitsavos Christos H, Chrysohoou Christina, Panagiotakos Demosthenes B, Kokkinos Peter, Skoumas John, Papaioannou Ioanna, Michaelides Andreas P, Singh Steven, Stefanadis Christodoulos I
First Cardiology Department, School of Medicine, University of Athens, Greece.
Atherosclerosis. 2004 Apr;173(2):347-52. doi: 10.1016/j.atherosclerosis.2003.12.027.
Several clinical and observational studies have established that exercise capacity and activity status are strong predictors of cardiovascular and overall mortality. We aimed to evaluate the relationship between exercise tolerance test (ETT) indices and occurrence of coronary heart disease (CHD), in patients with heterozygous Familial Hypercholesterolemia (eFH).
During 1987-1997, we enrolled 639 cardiovascular disease-free patients with heterozygous eFH; 58 (9%) patients were excluded since they had a positive ETT. A fatal or non-fatal CHD event was the end point. Cox proportional hazards models were applied to evaluate the association between the investigated outcome and ETT indices.
During the follow-up (1987-2002), 53 (18%) men and 34 (10%) women developed a CHD event (11 were fatal). The age-adjusted event rate was 87 events per 2915 person-years (3%). Statistical analysis revealed that exercise capacity (hazard ratio = 0.82, P < 0.001), heart rate recovery at 1 min (hazard ratio = 0.91, P < 0.05), and peak pulse pressure levels (hazard ratio = 1.03, P < 0.001), were predictors of CHD, after controlling for several potential confounders.
Decreased exercise capacity, a delayed decrease in heart rate during the first minute of graded exercise, and increased peak pulse pressure are strong predictors of coronary events in patients with eFH. Physical activity should be strongly recommended in these patients.
多项临床和观察性研究已证实，运动能力和活动状态是心血管疾病及全因死亡率的有力预测指标。我们旨在评估杂合子家族性高胆固醇血症（eFH）患者运动耐量试验（ETT）指标与冠心病（CHD）发生之间的关系。
在1987年至1997年期间，我们纳入了639例无心血管疾病的杂合子eFH患者；其中58例（9%）患者因ETT结果呈阳性而被排除。以致命或非致命的CHD事件作为终点。应用Cox比例风险模型评估所研究结局与ETT指标之间的关联。
在随访期间（1987年至2002年），53例（18%）男性和34例（10%）女性发生了CHD事件（11例为致命事件）。年龄调整后的事件发生率为每2915人年87例事件（3%）。统计分析显示，在控制了多个潜在混杂因素后，运动能力（风险比=0.82，P<0.001）、运动后1分钟心率恢复情况（风险比=0.91，P<0.05）以及峰值脉压水平（风险比=1.
