Author/Authors :
Matsuzawa، نويسنده , , Yasushi and Konishi، نويسنده , , Masaaki and Akiyama، نويسنده , , Eiichi and Suzuki، نويسنده , , Hiroyuki and Nakayama، نويسنده , , Naoki and Kiyokuni، نويسنده , , Masayoshi and Sumita، نويسنده , , Shinichi and Ebina، نويسنده , , Toshiaki and Kosuge، نويسنده , , Masami and Hibi، نويسنده , , Kiyoshi and Tsukahara، نويسنده , , Kengo and Iwahashi، نويسنده , , Noriaki and Endo، نويسنده , , Mitsuaki and Maejima، نويسنده , , Nobuhiko and Saka، نويسنده , , Kenichiro and Hashiba، نويسنده , , Katsutaka and Okada، نويسنده , , Kozo and Taguri، نويسنده , , Masataka and Morita، نويسنده , , Satoshi and Sugiyama، نويسنده , , Seigo and Ogawa، نويسنده , , Hisao and Sashika، نويسنده , , Hironobu and Umemura، نويسنده , , Satoshi and Kimura، نويسنده , , Kazuo، نويسنده ,
Abstract :
Objectives
tudy sought to determine the additional clinical value of gait speed to Framingham risk score (FRS), cardiac function, and comorbid conditions in predicting cardiovascular events in patients with ST-segment elevation myocardial infarction.
ound
is growing evidence that gait speed is inversely associated with all-cause mortality, particularly cardiovascular mortality, among the elderly.
s
ertook a single-center prospective observational study of gait speed in 472 patients with ST-segment elevation myocardial infarction in Japan, between 2001 and 2008. Gait speeds were measured using a 200-m course before discharge in all patients, and we followed up cardiovascular events, which consist of cardiovascular deaths, nonfatal myocardial infarctions, and nonfatal ischemic strokes.
s
the 2,596 person-years of follow-up, 83 patients (17.6%) experienced cardiovascular events. Cardiovascular events increased across decreasing tertiles of gait speed (fastest tertile: n = 5, 3.2%; middle tertile: n = 20, 12.6%; slowest tertile, n = 58, 36.7%). By multiple adjusted Cox proportional hazards analysis, gait speed was a significant and independent predictor of cardiovascular events (hazard ratio for increasing 0.1 m/s of gait speed: 0.71, 95% confidence interval [CI]: 0.63 to 0.81, p < 0.001). The addition of gait speed to the model incorporating FRS, B-type natriuretic peptide levels, and comorbidity index improved reclassification (net reclassification index: 32.8%, 95% CI: 17.4 to 48.3, p < 0.001) and the C-statistics with a reasonable global fit and calibration (C-statistics: from 0.703 [95% CI: 0.636 to 0.763] to 0.786 [95% CI: 0.738 to 0.829]).
sions
patients with ST-segment elevation myocardial infarction, slow gait speed was significantly associated with an increased risk of cardiovascular events. (Gait Speed for Predicting Cardiovascular Events After Myocardial Infarction; NCT01484158)
