title: Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study.
abstract: OBJECTIVE
  To determine whether the walking speed maintained during a 1 km treadmill test at moderate intensity predicts survival in patients with cardiovascular disease.
  
  
  METHODS
  Population-based prospective study.
  
  
  METHODS
  Outpatient secondary prevention programme in Ferrara, Italy.
  
  
  METHODS
  1255 male stable cardiac patients, aged 25-85 years at baseline.
  
  
  METHODS
  Walking speed maintained during a 1 km treadmill test, measured at baseline and mortality over a median follow-up of 8.2 years.
  
  
  RESULTS
  Among 1255 patients, 141 died, for an average annual mortality of 1.4%. Of the variables considered, the strongest predictor of all-cause mortality was walking speed (95% CI 0.45 to 0.75, p<0.0001). Based on the average speed maintained during the test, participants were subdivided into quartiles and mortality risk adjusted for confounders was calculated. Compared to the slowest quartile (average walking speed 3.4 km/h), the relative mortality risk decreased for the second, third and fourth quartiles (average walking speed 5.5 km/h), with HRs of 0.73 (95% CI 0.46 to 1.18); 0.54 (95% CI 0.31 to 0.95) and 0.20 (95% CI 0.07 to 0.56), respectively (p for trend <0.0001). Receiver operating curve analysis showed an area under the curve of 0.71 (p<0.0001) and the highest Youden index (0.35) for a walking speed of 4.0 km/h.
  
  
  CONCLUSIONS
  The average speed maintained during a 1 km treadmill walking test is inversely related to survival in patients with cardiovascular disease and is a simple and useful tool for stratifying risk in patients undergoing secondary prevention and cardiac rehabilitation programmes.
authors.affiliation: Center of Biomedical Studies Applied to Sport, University of Ferrara, Ferrara, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Chiaranda
authors.forename: Eva
authors.initials: E
authors.lastname: Bernardi
authors.forename: Luciano
authors.initials: L
authors.lastname: Codecà
authors.forename: Francesco
authors.initials: F
authors.lastname: Conconi
authors.forename: Jonathan
authors.initials: J
authors.lastname: Myers
authors.forename: Francesco
authors.initials: F
authors.lastname: Terranova
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.forename: Gianni
authors.initials: G
authors.lastname: Mazzoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grazzi
keywords: cardiac patients; survival; walking speed