Cardiovascular disease (CVD) is the principal cause of death in US women. Peak oxygen
uptake (VO2peak) is strongly related to mortality and CVD. This study aimed to investigate the association
between estimated VO2peak, determined using a moderate 1-km walking test (1k-TWT), and all-cause mortality
in female patients with stable CVD.
Of the 482 women comprising in our registry between 1997-2020, we included 430 participants
in the analysis (age 67 [34-88] years). A Cox proportional hazard model was used to
determine variables significantly associated with mortality. Based on the VO2peak estimated using the 1k-TWT, the sample was subdivided into tertiles, and mortality
risk was calculated. The discriminatory accuracy of VO2peak in estimating survival was assessed by receiver-operating-characteristic (ROC) curves.
All results were adjusted for demographic and clinical covariates.
A total of 135 deaths from any cause occurred over a median of 10.4 years (IQR 4.4-16.4),
with an average annual mortality of 4.2%. Estimated VO2peak was a stronger predictor of all-cause mortality than demographic and clinical variables
(c-statistic 0.767, 95% CI: 0.72-0.81, p<0.0001). The survival rate decreased from
the highest tertile of fitness to the lowest. Compared to the lowest group, hazard
ratios (95% confidence intervals) for the second and third tertiles were 0.55 (0.37-0.83)
and 0.29 (0.16-0.51), respectively (p for trend <0.0001).
Higher VO2peak levels were associated with a lower risk of all-cause mortality. The indirect estimation
of VO2peak using the 1k-TWT is feasible and can be applied for risk stratification among female
patients undergoing secondary prevention programs.
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