Bruce R A, Fisher L D
Aviat Space Environ Med. 1987 Aug;58(8):792-8.
Exercise-enhanced risk assessment for subsequent morbidity and mortality due to coronary heart disease is examined in 4105 asymptomatic healthy men of 15 to 80 years of age (mean of 44.7 years) observed in Seattle community practice. Annual incidence of primary coronary events averages 0.22% in 1792 men (43.6%) without conventional risk factors, and 0.42% in the majority of men (55.3%) with risk factor(s), but less than two abnormal responses to maximal exercise. Among 44 men (1.1%) at high risk defined by any conventional risk factor(s) and two or more abnormal responses to maximal exercise, annual incidence of primary coronary events averages 5.2% (p less than 0.001). The proportion of men of 60-64 years at low risk with a 98% 3-year survival rate is 16 times that of men of 55-59 years at high risk with a 78% survival rate in this asymptomatic population. Of 1718 men under 60 years of age and without conventional risk factors, 117 or 6.8% developed ischemic ST depression with maximal exercise testing, but none reported any coronary event during 5.6 years of follow-up surveillance.
在西雅图社区诊所对4105名年龄在15至80岁（平均44.7岁）的无症状健康男性进行了研究，以检验运动增强的冠心病后续发病和死亡风险评估。在1792名（43.6%）无传统风险因素的男性中，原发性冠状动脉事件的年发病率平均为0.22%；在大多数（55.3%）有风险因素但对最大运动测试的异常反应少于两项的男性中，年发病率为0.42%。在由任何传统风险因素定义为高危且对最大运动测试有两项或更多异常反应的44名男性（1.1%）中，原发性冠状动脉事件的年发病率平均为5.2%（p<0.001）。在这个无症状人群中，60 - 64岁低风险男性3年生存率为98%，是55 - 59岁高风险男性生存率78%的16倍。在1718名60岁以下且无传统风险因素的男性中，117名（6.8%）在最大运动测试时出现缺血性ST段压低，但在5.6年的随访监测中无人报告任何冠状动脉事件。
