Association of post-diagnosis cardiorespiratory fitness with cause-specific mortality in cancer
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com..
AIMS: The prognostic importance of post-diagnosis assessment of cardiorespiratory fitness (CRF) in cancer patients is not well established. We sought to examine the association between CRF and mortality in cancer patients.
METHODS AND RESULTS: This was a single-centre cohort analysis of 1632 patients (58% male; 64 ± 12 years) with adult-onset cancer who were clinically referred for exercise treadmill testing a median of 7 [interquartile range (IQR): 3-12] years after primary diagnosis. Cardiorespiratory fitness was defined as peak metabolic equivalents (METs) achieved during standard Bruce protocol and categorized by tertiles. The association between CRF and all-cause and cause-specific mortality was assessed using multivariable Cox proportional hazard models adjusting for important covariates. Median follow-up was 4.6 (IQR: 2.6-7.0) years; a total of 411 deaths (229, 50, and 132 all-cause, cardiovascular (CV), and cancer related, respectively) occurred during this period. Compared with low CRF (range: 1.9-7.6 METs), the adjusted hazard ratio (HR) for all-cause mortality was 0.38 [95% confidence interval (CI): 0.28-0.52] for intermediate CRF (range: 7.7-10.6 METs) and 0.17 (95% CI: 0.11-0.27) for high CRF (range: 10.7-22.0 METs). The corresponding HRs were 0.40 (95% CI: 0.19-0.86) and 0.41 (95% CI: 0.16-1.05) for CV mortality and 0.40 (95% CI: 0.26-0.60) and 0.16 (95% CI: 0.09-0.28) for cancer mortality, respectively. The adjusted risk of all-cause, CV, and cancer mortality decreased by 26%, 14%, and 25%, respectively with each one MET increment in CRF.
CONCLUSION: Cardiorespiratory fitness is a strong, independent predictor of all-cause, CV, and cancer mortality, even after adjustment for important clinical covariates in patients with certain cancers.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
European heart journal. Quality of care & clinical outcomes - 6(2020), 4 vom: 01. Okt., Seite 315-322 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Groarke, John D [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer |
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| Anmerkungen: |
Date Completed 05.07.2021 Date Revised 09.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ehjqcco/qcaa015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307556611 |
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| 100 | 1 | |a Groarke, John D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of post-diagnosis cardiorespiratory fitness with cause-specific mortality in cancer |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 05.07.2021 | ||
| 500 | |a Date Revised 09.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: The prognostic importance of post-diagnosis assessment of cardiorespiratory fitness (CRF) in cancer patients is not well established. We sought to examine the association between CRF and mortality in cancer patients | ||
| 520 | |a METHODS AND RESULTS: This was a single-centre cohort analysis of 1632 patients (58% male; 64 ± 12 years) with adult-onset cancer who were clinically referred for exercise treadmill testing a median of 7 [interquartile range (IQR): 3-12] years after primary diagnosis. Cardiorespiratory fitness was defined as peak metabolic equivalents (METs) achieved during standard Bruce protocol and categorized by tertiles. The association between CRF and all-cause and cause-specific mortality was assessed using multivariable Cox proportional hazard models adjusting for important covariates. Median follow-up was 4.6 (IQR: 2.6-7.0) years; a total of 411 deaths (229, 50, and 132 all-cause, cardiovascular (CV), and cancer related, respectively) occurred during this period. Compared with low CRF (range: 1.9-7.6 METs), the adjusted hazard ratio (HR) for all-cause mortality was 0.38 [95% confidence interval (CI): 0.28-0.52] for intermediate CRF (range: 7.7-10.6 METs) and 0.17 (95% CI: 0.11-0.27) for high CRF (range: 10.7-22.0 METs). The corresponding HRs were 0.40 (95% CI: 0.19-0.86) and 0.41 (95% CI: 0.16-1.05) for CV mortality and 0.40 (95% CI: 0.26-0.60) and 0.16 (95% CI: 0.09-0.28) for cancer mortality, respectively. The adjusted risk of all-cause, CV, and cancer mortality decreased by 26%, 14%, and 25%, respectively with each one MET increment in CRF | ||
| 520 | |a CONCLUSION: Cardiorespiratory fitness is a strong, independent predictor of all-cause, CV, and cancer mortality, even after adjustment for important clinical covariates in patients with certain cancers | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cancer | |
| 650 | 4 | |a Cancer mortality | |
| 650 | 4 | |a Cardiac rehab | |
| 650 | 4 | |a Cardio-oncology | |
| 650 | 4 | |a Cardiorespiratory fitness | |
| 650 | 4 | |a Cardiovascular mortality | |
| 650 | 4 | |a Cause-specific mortality | |
| 650 | 4 | |a Exercise | |
| 650 | 4 | |a Mortality | |
| 700 | 1 | |a Payne, David L |e verfasserin |4 aut | |
| 700 | 1 | |a Claggett, Brian |e verfasserin |4 aut | |
| 700 | 1 | |a Mehra, Mandeep R |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Jingyi |e verfasserin |4 aut | |
| 700 | 1 | |a Caron, Jesse |e verfasserin |4 aut | |
| 700 | 1 | |a Mahmood, Syed S |e verfasserin |4 aut | |
| 700 | 1 | |a Hainer, Jon |e verfasserin |4 aut | |
| 700 | 1 | |a Neilan, Tomas G |e verfasserin |4 aut | |
| 700 | 1 | |a Partridge, Ann H |e verfasserin |4 aut | |
| 700 | 1 | |a Di Carli, Marcelo |e verfasserin |4 aut | |
| 700 | 1 | |a Jones, Lee W |e verfasserin |4 aut | |
| 700 | 1 | |a Nohria, Anju |e verfasserin |4 aut | |
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