title: Coronary artery calcium, exercise tolerance, and CHD events in asymptomatic men.
abstract: Coronary artery calcium (CAC) scores >/=100 are predictive of CHD events in asymptomatic men. Exercise tolerance of >/=10METs predicts lower event rates in CHD patients; however, its relationship with events in individuals with subclinical atherosclerosis is less known. Participants were 710 asymptomatic men from the Aerobics Center Longitudinal Study whose exercise tolerance (ET) was quantified (<10 or >/=10METs) and whose CAC score was >/=100 as measured by electron beam tomography. During 3.5 years of follow-up 59 CHD events occurred. The age-adjusted hazard ratio (HR) of CHD events was 0.26 (95% CI=0.15-0.45) in men whose ET was >/=10METs compared with men whose ET was <10METs. Adjustment for CHD risk factors and abnormal exercise ECG did not change the association between ET and CHD. The extent of underlying atherosclerosis did not influence the association between ET and CHD; for example, the HR for CHD events in the >/=10MET group among men with CAC scores <400 and >/=400 was 0.16 (95% CI=0.05-0.56) and 0.23 (95% CI=0.11-0.46), respectively. In asymptomatic men with subclinical coronary atherosclerosis, an ET of >/=10METs identifies patients at lower risk for manifest CHD.
authors.affiliation: The Cooper Institute, 12330 Preston Rd, Dallas, TX 75230, USA. mlamonte@cooperinst.org
authors.forename: Michael J
authors.initials: MJ
authors.lastname: LaMonte
authors.forename: Shannon J
authors.initials: SJ
authors.lastname: Fitzgerald
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Levine
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.forename: James B
authors.initials: JB
authors.lastname: Kampert
authors.forename: Milton Z
authors.initials: MZ
authors.lastname: Nichaman
authors.forename: Larry W
authors.initials: LW
authors.lastname: Gibbons
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D002118:Calcium / Q000378:metabolism*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D003331:Coronary Vessels / Q000378:metabolism*; D017079:Exercise Tolerance / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D002118:Calcium