The prognostic value of a nomogram for exercise capacity in women - PubMed (original) (raw)
. 2005 Aug 4;353(5):468-75.
doi: 10.1056/NEJMoa044154.
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- PMID: 16079370
- DOI: 10.1056/NEJMoa044154
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The prognostic value of a nomogram for exercise capacity in women
Martha Gulati et al. N Engl J Med. 2005.
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Abstract
Background: Recent studies have demonstrated that exercise capacity is an independent predictor of mortality in women. Normative values of exercise capacity for age in women have not been well established. Our objectives were to construct a nomogram to permit determination of predicted exercise capacity for age in women and to assess the predictive value of the nomogram with respect to survival.
Methods: A total of 5721 asymptomatic women underwent a symptom-limited, maximal stress test. Exercise capacity was measured in metabolic equivalents (MET). Linear regression was used to estimate the mean MET achieved for age. A nomogram was established to allow the percentage of predicted exercise capacity to be estimated on the basis of age and the exercise capacity achieved. The nomogram was then used to determine the percentage of predicted exercise capacity for both the original cohort and a referral population of 4471 women with cardiovascular symptoms who underwent a symptom-limited stress test. Survival data were obtained for both cohorts, and Cox survival analysis was used to estimate the rates of death from any cause and from cardiac causes in each group.
Results: The linear regression equation for predicted exercise capacity (in MET) on the basis of age in the cohort of asymptomatic women was as follows: predicted MET = 14.7 - (0.13 x age). The risk of death among asymptomatic women whose exercise capacity was less than 85 percent of the predicted value for age was twice that among women whose exercise capacity was at least 85 percent of the age-predicted value (P<0.001). Results were similar in the cohort of symptomatic women.
Conclusions: We have established a nomogram for predicted exercise capacity on the basis of age that is predictive of survival among both asymptomatic and symptomatic women. These findings could be incorporated into the interpretation of exercise stress tests, providing additional prognostic information for risk stratification.
Copyright 2005 Massachusetts Medical Society.
Comment in
- Where does fitness fit in?
Kraus WE, Douglas PS. Kraus WE, et al. N Engl J Med. 2005 Aug 4;353(5):517-9. doi: 10.1056/NEJMe058132. N Engl J Med. 2005. PMID: 16079377 No abstract available. - Nomogram for exercise capacity in women.
Hossack KF. Hossack KF. N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3. doi: 10.1056/NEJM200511243532120. N Engl J Med. 2005. PMID: 16306532 No abstract available. - Nomogram for exercise capacity in women.
Haas F, Byrne NM, Rey M. Haas F, et al. N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3. N Engl J Med. 2005. PMID: 16312064 No abstract available. - Nomogram for exercise capacity in women.
Pletcher MJ, McCulloch C. Pletcher MJ, et al. N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3. N Engl J Med. 2005. PMID: 16312065 No abstract available. - A nomogram of exercise capacity for age predicted mortality in women with cardiovascular symptoms.
Granger C. Granger C. ACP J Club. 2006 Jan-Feb;144(1):25. ACP J Club. 2006. PMID: 16388574 No abstract available.
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