Six-minute walking test but not ejection fraction predicts mortality in elderly patients undergoing cardiac rehabilitation following coronary artery bypass grafting

Eur J Prev Cardiol. 2012 Dec;19(6):1401-9. doi: 10.1177/1741826711422991. Epub 2011 Sep 20.

Abstract

Background: Age-related effects on the ability of 6-min walking test (6MWT) and ejection fraction (EF) to predict mortality in coronary artery bypass grafting (CABG) patients undergoing cardiac rehabilitation (CR) is still debated.

Design and methods: In order to verify the role of 6MWT and EF on all-cause mortality in patients undergoing CR following CABG, 882 CABG patients undergoing CR stratified in adults (<65 years) and elderly (≥65 years) were studied.

Results: At the admission, EF was 52.6 ± 9.1% in adults and 51.3 ± 8.9% in elderly (p = 0.234, NS) while 6MWT was 343.8 ± 93.5 m in adults and 258.9 ± 95.7 m in elderly (p < 0.001). After 42.9 ± 14.1 months follow up, mortality was 8.2% in adults and 10.9% in elderly (p = 0.176, NS). Cox regression analysis shows that EF ≥ 50% and 6MWT ≥300 m are protective on mortality in all CABG patients before CR. However, EF ≥50% in adults (HR 0.18, 95% CI 0.06-0.49, p < 0.005) but not in elderly (HR 1.16, 95% CI 0.45-3.42, p = 0.354, NS) and 6MWT ≥300 m in elderly (HR 0.34, 95% CI 0.10-0.79, p = 0.033) but not in adults (HR 0.76, 95% CI 0.31-2.12, p = 0.654, NS) exert a protective role on mortality.

Conclusions: Our results indicate that both EF ≥ 50% and 6MWT ≥ 300 m independently protect against mortality in CABG patients before CR. However, their protective role is age dependent. In fact, EF ≥ 50% is protective in adults but not in elderly while 6MWT ≥ 300 m is protective in elderly but not in adult patients.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Age Factors
  • Aged
  • Chi-Square Distribution
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / mortality*
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / rehabilitation*
  • Coronary Artery Disease / surgery*
  • Exercise Test*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Stroke Volume*
  • Treatment Outcome
  • Walking*