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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 6-7页

作者： Aktas m.K. Ozduran V. Pothier C.E. m.S. Lauer 任付先 Cleveland Clinic Foundation 9500 Euclid Ave Cleveland OH 44 195 United States Dr.

Context: The usefulness of exercise stress test results and global cardiovascu lar risk systems for predicting all cause mortality in asymptomatic individuals seen in clinical settings is unclear. Objectives: To determine the validity for prediction of all cause mortality of the Framingham Risk Score and of a recent ly described European global scoring system Systematic Coronary Risk Evaluation (SCORE) for cardiovascular mortality among asymptomatic individuals evaluated in a clinical setting and to determine the potential prognostic value of exercise stress testing once these baseline risks are known. Design, Setting, and Partici pants: Prospective cohort study of 3554 asymptomatic adults between the ages of 50 and 75 years who underwent exercise stress testing as part of an executive he alth program between October 1990 and December 2002; participants were followed up for a mean of 8 years. main Outcome measures: Global risk based on the Framin gham Risk Score and the European SCORE. Prospectively recorded exercise stress t est result abnormalities included impaired physical fitness, abnormal heart rate recovery, ventricular ectopy, and ST segment abnormalities. The primary end po int was all cause mortality. Results: There were 114 deaths. The c index, whic h corresponds to receiver operating characteristic curve values, and the Akaike information Criteria found that the European SCORE was superior to the Framingha m Risk Score in estimating global mortality risk. in a multivariable model, independent predictors of death were a higher SCORE (for 1%predicted increase in absolute risk, relative risk [RR], 1.07; 95%con fi dence interval [Ci], 1.04-1.09; Pimpaired functional capacity (RR, 2 .9 5; 95%Ci, 1.98-4.39; Pmal heart rate recovery (RR, 1.59; 95%, 1.04-2.41; P=.03). ST segment depression did not predict mortality. Amon g patients in the highest tertile from the SCORE, an abnormal exercise stress te st result, defined as either imp

关键词：运动试验全因死亡率运动应激全球风险无症状心血管风险死亡风险试验结果异位激动预后价值

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