External Prognostic Validations and Comparisons of Age- and Gender-Adjusted Exercise Capacity Predictions

• Published in: Journal of the American College of Cardiology Vol. 50; no. 19; pp. 1867 - 1875
• Main Authors: Kim, Esther S.H., MD, MPH, Ishwaran, Hemant, PhD, Blackstone, Eugene, MD, FACC, Lauer, Michael S., MD, FACC, FAHA
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 06.11.2007; Elsevier Science; Elsevier Limited
• Subjects: Adult; Age; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Blood Pressure - physiology; Cardiology; Cardiology. Vascular system; Cardiomyopathy; Cardiovascular; Cardiovascular disease; Cause of Death; Coronary Disease - mortality; Coronary Disease - physiopathology; Electrocardiography; Exercise; Exercise Test; Female; Fitness equipment; Gender; Heart; Heart attacks; Heart rate; Heart Rate - physiology; Humans; Hypertension; Internal Medicine; Male; Medical sciences; Middle Aged; Mortality; Multivariate Analysis; Nomograms; Patients; Physical Exertion - physiology; Physical Fitness - physiology; Predictive Value of Tests; Preventive medicine; Prognosis; Prospective Studies; Risk Factors; Sex Factors; Survival Analysis; Women; metabolic equivalent; exercise capacity; Veterans Affairs; AIC; VA; MET; Akaike Information Criterion; EC; Physical exercise; Validation; Prognosis; Prediction; Sex; Phlebology; Capacity; External; Exercise tolerance test; Circulatory system; Cardiology; Predictive factor; Age; Comparative study
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.08.003

External Prognostic Validations and Comparisons of Age- and Gender-Adjusted Exercise Capacity Predictions Esther S. H. Kim, Hemant Ishwaran, Eugene Blackstone, Michael S. Lauer Exercise capacity (EC) predicts death, and although several nomograms describe EC, accounting for age and gender-related differences, their ability to predict mortality differs. We used 4 statistical methods to externally validate the prognostic value of age- and gender-based nomograms and categorical definitions of impaired EC in a cohort of 22,275 patients without known heart disease who underwent exercise testing and were followed for a median of 5 years. We conclude that simple cutoff values fail to fully describe EC’s strong predictive value, and we report an important interaction with age, whereby predicted EC is a weaker predictor in older subjects.