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The Value of Estimated Functional Capacity in Estimating Outcome

Results From the NHBLI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study

Leslee J. Shaw, PhD^_*,_*, Marian B. Olson, MS, Kevin Kip, PhD, Sheryl F. Kelsey, PhD, B. Delia Johnson, PhD, Daniel B. Mark, MD, Steven E. Reis, MD^_*, Sunil Mankad, MD, William J. Rogers, MD^||, Gerald M. Pohost, MD^¶, Christopher B. Arant, MD^#, Timothy R. Wessel, MD^#, Bernard R. Chaitman, MD^_**, George Sopko, MD, Eileen Handberg, PhD^#, Carl J. Pepine, MD^# and C. Noel Bairey Merz, MD^_*

^_* Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
Duke Clinical Research Institute, Duke University, Durham, North Carolina
Division of Cardiology, Department of Medicine, Allegheny University of Health Sciences, Pittsburgh, Pennsylvania
^|| Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
^¶ Division of Cardiology, University of Southern California, Los Angeles, California
^# Division of Cardiology, Department of Medicine, University of Florida, Gainesville, Florida
^_** St. Louis University Medical Center, St. Louis, Missouri
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

View larger version (14K): [in a new window]   Figure 1 Death or myocardial infarction-free survival by Duke Activity Status Index measurements of metabolic equivalents (METs), using Bruce protocol stage cutpoints (n = 914). Five-year survival corresponds to 95%, 92%, 88%, and 85% for >9.9, 7.5 to 9.9, 4.8 to 7.4, and 1 to 4.7 METs, respectively (p = 0.009).

View larger version (15K): [in a new window]   Figure 2 Annualized total cardiovascular event rates by exercise stress testing and Duke Activity Status Index (DASI)-estimated metabolic equivalents (METs) in 251 symptomatic women. p = 0.007 for exercise and p < 0.0001 for DASI based upon the univariable Cox model for exercise and DASI METs.