心肺适能与中风类型的关系：FIT（亨利福特运动测试）项目。

Cardiorespiratory Fitness and Incident Stroke Types: The FIT (Henry Ford ExercIse Testing) Project.

机构信息

Section of Cardiology, Baylor College of Medicine, Houston, TX; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.

The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD.

出版信息

Mayo Clin Proc. 2020 Jul;95(7):1379-1389. doi: 10.1016/j.mayocp.2019.11.027.

DOI:10.1016/j.mayocp.2019.11.027

PMID:32622446

Abstract

OBJECTIVE

To study the association between cardiorespiratory fitness (CRF) and incident stroke types.

PATIENTS AND METHODS

We studied a retrospective cohort of patients referred for treadmill stress testing in the Henry Ford Health System (Henry Ford ExercIse Testing Project) without history of stroke. CRF was expressed by metabolic equivalents of task (METs). Using appropriate International Classification of Diseases, Ninth Revision codes, incident stroke was ascertained through linkage with administrative claims files and classified as ischemic, hemorrhagic, and subarachnoid hemorrhage (SAH). Multivariable-adjusted Cox proportional hazards models examined the association between CRF and incident stroke.

RESULTS

Among 67,550 patients, mean ± SD age was 54±13 years, 46% (n=31,089) were women, and 64% (n=43,274) were white. After a median follow-up of 5.4 (interquartile range 2.7-8.5) years, a total of 7512 incident strokes occurred (6320 ischemic, 2481 hemorrhagic, and 275 SAH). Overall, there was a graded lower incidence of stroke with higher MET categories. Patients with METs of 12 or more had lower risk of overall stroke [0.42 (95% CI, 0.36-0.49)], ischemic stroke [0.69 (95% CI, 0.58-0.82)], and hemorrhagic stroke [0.71 (95% CI, 0.52-0.95)].

CONCLUSION

In a large ethnically diverse cohort of patients referred for treadmill stress testing, CRF is inversely associated with risk for ischemic and hemorrhagic stroke.

摘要

目的

研究心肺适能（CRF）与卒中类型发生的关系。

患者和方法

我们研究了亨利福特健康系统（Henry Ford ExercIse Testing Project）中没有卒中病史的接受跑步机压力测试的回顾性队列患者。CRF 用代谢当量（METs）表示。使用适当的国际疾病分类，第九修订版代码，通过与行政索赔文件的链接确定卒中的发生，并将其分类为缺血性、出血性和蛛网膜下腔出血（SAH）。多变量调整的 Cox 比例风险模型研究了 CRF 与卒中发生的关系。

结果

在 67550 名患者中，平均±标准差年龄为 54±13 岁，46%（n=31089）为女性，64%（n=43274）为白人。中位随访 5.4 年后（四分位间距 2.7-8.5），共发生 7512 例卒中事件（6320 例缺血性、2481 例出血性和 275 例 SAH）。总体而言，随着 MET 类别增加，卒中的发生率逐渐降低。MET 为 12 或更高的患者整体卒中风险较低[0.42（95%置信区间，0.36-0.49）]，缺血性卒中风险较低[0.69（95%置信区间，0.58-0.82）]，出血性卒中风险较低[0.71（95%置信区间，0.52-0.95）]。