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Can exercise capacity assessed by the 6 minute walk test predict the development of major adverse cardiac events in patients with STEMI after fibrinolysis?

Hassan AK, Dimitry SR, Agban GW - PLoS ONE (2014)

Bottom Line: The mean age was 60.9±10.7 years, 71.9% of them were males, 2/3 had anterior MI. only 10.5% had successful thrombolysis.There was a significant negative correlation between the 6 MWTD and GRACE risk score (r = -0.80, p<0.001).Multivariate logistic regression analysis identified that the GRACE risk score and 6MWT distance levels were the best predictors of the MACE at 3 month of follow up.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.

ABSTRACT

Background: To assess the added value of the 6 minute walk test distance (6MWTD) in the risk-stratification methods for patients with ST -segment elevation myocardial infarction (STEMI) treated with fibrinolysis.

Methodology/principal findings: This is a prospective cohort study of one hundred consecutive patients with STEMI, who had received fibrinolysis, at Assuit University Hospital. All patients underwent 6MWT pre- discharge and were followed up for 3 months to monitor the incidence of major adverse cardiac events (MACE). Patients were divided into 3 groups according to the level of 6MWTD (level I>450 m, level II = 300-450 m and level III<300 m). Among the study population, the median 6MWT distance was 370 meters (interquartile range 162-462). The mean age was 60.9±10.7 years, 71.9% of them were males, 2/3 had anterior MI. only 10.5% had successful thrombolysis. Compared to patients in level I (>450 m), patients in level III (<300 m) were more likely to have clinical risk factors as hypertension, diabetes and impaired renal function. The patient's mean TIMI score was 3.4±2.2, the mean GRACE score was 150.5±27.7. There was a significant negative correlation between the 6 MWTD and GRACE risk score (r = -0.80, p<0.001). At 3 months of follow-up, 51% had MACE including 16% were dead. Multivariate logistic regression analysis identified that the GRACE risk score and 6MWT distance levels were the best predictors of the MACE at 3 month of follow up. The incidence of MACE was 4 times higher in patients with high GRACE risk score who couldn't walk more than 300 meters (OR = 4.66, 95% CI = 1.1-14.5, p = 0.006).

Conclusions/significance: In patients with STEMI treated with fibrinolysis, the addition of 6MWTD assessment pre-discharge to the traditional GRACE risk score improved the risk prediction of cardiovascular events at 3 month follow up.

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Six-minute walk test distance by GRACE risk score.
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pone-0099035-g001: Six-minute walk test distance by GRACE risk score.

Mentions: Six-minute walk test was compared with GRACE risk score. There was a significant negative correlation between 6 MWT distance and GRACE risk score (r = −0.80, p<0.001) (Figure 1).


Can exercise capacity assessed by the 6 minute walk test predict the development of major adverse cardiac events in patients with STEMI after fibrinolysis?

Hassan AK, Dimitry SR, Agban GW - PLoS ONE (2014)

Six-minute walk test distance by GRACE risk score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048282&req=5

pone-0099035-g001: Six-minute walk test distance by GRACE risk score.
Mentions: Six-minute walk test was compared with GRACE risk score. There was a significant negative correlation between 6 MWT distance and GRACE risk score (r = −0.80, p<0.001) (Figure 1).

Bottom Line: The mean age was 60.9±10.7 years, 71.9% of them were males, 2/3 had anterior MI. only 10.5% had successful thrombolysis.There was a significant negative correlation between the 6 MWTD and GRACE risk score (r = -0.80, p<0.001).Multivariate logistic regression analysis identified that the GRACE risk score and 6MWT distance levels were the best predictors of the MACE at 3 month of follow up.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.

ABSTRACT

Background: To assess the added value of the 6 minute walk test distance (6MWTD) in the risk-stratification methods for patients with ST -segment elevation myocardial infarction (STEMI) treated with fibrinolysis.

Methodology/principal findings: This is a prospective cohort study of one hundred consecutive patients with STEMI, who had received fibrinolysis, at Assuit University Hospital. All patients underwent 6MWT pre- discharge and were followed up for 3 months to monitor the incidence of major adverse cardiac events (MACE). Patients were divided into 3 groups according to the level of 6MWTD (level I>450 m, level II = 300-450 m and level III<300 m). Among the study population, the median 6MWT distance was 370 meters (interquartile range 162-462). The mean age was 60.9±10.7 years, 71.9% of them were males, 2/3 had anterior MI. only 10.5% had successful thrombolysis. Compared to patients in level I (>450 m), patients in level III (<300 m) were more likely to have clinical risk factors as hypertension, diabetes and impaired renal function. The patient's mean TIMI score was 3.4±2.2, the mean GRACE score was 150.5±27.7. There was a significant negative correlation between the 6 MWTD and GRACE risk score (r = -0.80, p<0.001). At 3 months of follow-up, 51% had MACE including 16% were dead. Multivariate logistic regression analysis identified that the GRACE risk score and 6MWT distance levels were the best predictors of the MACE at 3 month of follow up. The incidence of MACE was 4 times higher in patients with high GRACE risk score who couldn't walk more than 300 meters (OR = 4.66, 95% CI = 1.1-14.5, p = 0.006).

Conclusions/significance: In patients with STEMI treated with fibrinolysis, the addition of 6MWTD assessment pre-discharge to the traditional GRACE risk score improved the risk prediction of cardiovascular events at 3 month follow up.

Show MeSH
Related in: MedlinePlus