Mahmoud Al Rifai1, Michael J Blaha2, Amjad Ahmed3, Fatimah Almasoudi3, Michelle C Johansen4, Waqas Qureshi5, Sherif Sakr3, Salim S Virani6, Clinton A Brawner7, Jonathan K Ehrman7, Steven J Keteyian7, Mouaz H Al-Mallah8. 1. Section of Cardiology, Baylor College of Medicine, Houston, TX; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD. 2. The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD. 3. King Abdul Aziz Cardiac Center, Riyadh, Saudi Arabia. 4. Department of Neurology, Johns Hopkins University, Baltimore, MD. 5. Division of Cardiology, University of Massachusetts Medical School, Worcester, MA. 6. Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX; Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, Houston, TX; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. 7. Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI. 8. Department of Cardiac Imaging, Houston Methodist DeBakey Heart & Vascular Center, TX. Electronic address: mouaz74@gmail.com.
Abstract
OBJECTIVE: To study the association between cardiorespiratory fitness (CRF) and incident stroke types. PATIENTS AND METHODS: We studied a retrospective cohort of patients referred for treadmill stress testing in the Henry Ford Health System (Henry Ford ExercIse Testing Project) without history of stroke. CRF was expressed by metabolic equivalents of task (METs). Using appropriate International Classification of Diseases, Ninth Revision codes, incident stroke was ascertained through linkage with administrative claims files and classified as ischemic, hemorrhagic, and subarachnoid hemorrhage (SAH). Multivariable-adjusted Cox proportional hazards models examined the association between CRF and incident stroke. RESULTS: Among 67,550 patients, mean ± SD age was 54±13 years, 46% (n=31,089) were women, and 64% (n=43,274) were white. After a median follow-up of 5.4 (interquartile range 2.7-8.5) years, a total of 7512 incident strokes occurred (6320 ischemic, 2481 hemorrhagic, and 275 SAH). Overall, there was a graded lower incidence of stroke with higher MET categories. Patients with METs of 12 or more had lower risk of overall stroke [0.42 (95% CI, 0.36-0.49)], ischemic stroke [0.69 (95% CI, 0.58-0.82)], and hemorrhagic stroke [0.71 (95% CI, 0.52-0.95)]. CONCLUSION: In a large ethnically diverse cohort of patients referred for treadmill stress testing, CRF is inversely associated with risk for ischemic and hemorrhagic stroke.
OBJECTIVE: To study the association between cardiorespiratory fitness (CRF) and incident stroke types. PATIENTS AND METHODS: We studied a retrospective cohort of patients referred for treadmill stress testing in the Henry Ford Health System (Henry Ford ExercIse Testing Project) without history of stroke. CRF was expressed by metabolic equivalents of task (METs). Using appropriate International Classification of Diseases, Ninth Revision codes, incident stroke was ascertained through linkage with administrative claims files and classified as ischemic, hemorrhagic, and subarachnoid hemorrhage (SAH). Multivariable-adjusted Cox proportional hazards models examined the association between CRF and incident stroke. RESULTS: Among 67,550 patients, mean ± SD age was 54±13 years, 46% (n=31,089) were women, and 64% (n=43,274) were white. After a median follow-up of 5.4 (interquartile range 2.7-8.5) years, a total of 7512 incident strokes occurred (6320 ischemic, 2481 hemorrhagic, and 275 SAH). Overall, there was a graded lower incidence of stroke with higher MET categories. Patients with METs of 12 or more had lower risk of overall stroke [0.42 (95% CI, 0.36-0.49)], ischemic stroke [0.69 (95% CI, 0.58-0.82)], and hemorrhagic stroke [0.71 (95% CI, 0.52-0.95)]. CONCLUSION: In a large ethnically diverse cohort of patients referred for treadmill stress testing, CRF is inversely associated with risk for ischemic and hemorrhagic stroke.
Authors: Yasunori Toyota; Hajime Shishido; Fenghui Ye; Lauren G Koch; Steven L Britton; Hugh J L Garton; Richard F Keep; Guohua Xi; Ya Hua Journal: Int J Mol Sci Date: 2021-04-26 Impact factor: 5.923