Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial
Abstract Aims This study aimed to investigate the impact of baseline 6 min walk test distance (6MWTD) on time to major cardiovascular (CV) events in heart failure with reduced ejection fraction (HFrEF) and its impact in clinically relevant subgroups. Methods and results In the WARCEF (Warfarin versu...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-04-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13068 |
| _version_ | 1818619160983240704 |
|---|---|
| author | Kenji Matsumoto Yi Xiao Shunichi Homma John L.P. Thompson Richard Buchsbaum Kazato Ito Stefan D. Anker Min Qian Marco R. Di Tullio for the WARCEF Investigators |
| author_facet | Kenji Matsumoto Yi Xiao Shunichi Homma John L.P. Thompson Richard Buchsbaum Kazato Ito Stefan D. Anker Min Qian Marco R. Di Tullio for the WARCEF Investigators |
| author_sort | Kenji Matsumoto |
| collection | DOAJ |
| description | Abstract Aims This study aimed to investigate the impact of baseline 6 min walk test distance (6MWTD) on time to major cardiovascular (CV) events in heart failure with reduced ejection fraction (HFrEF) and its impact in clinically relevant subgroups. Methods and results In the WARCEF (Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction) trial, 6MWTD at baseline was available in 2102 HFrEF patients. Median follow‐up was 3.4 years. All‐cause death and heart failure hospitalization (HFH) exhibited a significant non‐linear relationship with 6MWTD (P = 0.023 and 0.032, respectively), whereas a significant association between 6MWTD and CV death was shown in a linear model [hazard ratio (HR) per 10 m increase, 0.989; P = 0.011]. In linear splines with the best cut‐off point at 200 m, the positive effect of a longer 6MWTD on all‐cause death and HFH was only observed for 6MWTD > 200 m (HR per 10 m increase, 0.987; P = 0.0036 and 0.986; P = 0.0022, respectively). The associations between 6MWTD and CV outcomes were consistent across clinical subgroups; for age, a significant relationship between 6MWTD and HFH was observed in patients ≥60 years (HR per 10 m increase, 0.98; P < 0.001), but not in patients <60 years (HR per 10 m increase, 1.00; P = 0.98; P = 0.02 for the interaction). Conclusions In HFrEF, 6MWTD is independently associated with all‐cause death, CV death, and HFH. 6MWTD of 200 m is the best cut‐off point for predicting these adverse events. The prognostic impact of 6MWTD for HFH was only observed in older patients. |
| first_indexed | 2024-12-16T17:33:05Z |
| format | Article |
| id | doaj.art-37b7b8831c124ee8ad53470c8fec524c |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-16T17:33:05Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-37b7b8831c124ee8ad53470c8fec524c2022-12-21T22:22:53ZengWileyESC Heart Failure2055-58222021-04-018281982810.1002/ehf2.13068Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trialKenji Matsumoto0Yi Xiao1Shunichi Homma2John L.P. Thompson3Richard Buchsbaum4Kazato Ito5Stefan D. Anker6Min Qian7Marco R. Di Tullio8for the WARCEF InvestigatorsDivision of Cardiology Columbia University Irving Medical Center 630 West 168th Street New York NY 10032 USADepartment of Biostatistics Columbia University Mailman School of Public Health New York NY USADivision of Cardiology Columbia University Irving Medical Center 630 West 168th Street New York NY 10032 USADepartment of Biostatistics Columbia University Mailman School of Public Health New York NY USADepartment of Biostatistics Columbia University Mailman School of Public Health New York NY USADivision of Cardiology Columbia University Irving Medical Center 630 West 168th Street New York NY 10032 USADepartment of Cardiology (CVK) Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité—Universitätsmedizin Berlin Berlin GermanyDepartment of Biostatistics Columbia University Mailman School of Public Health New York NY USADivision of Cardiology Columbia University Irving Medical Center 630 West 168th Street New York NY 10032 USAAbstract Aims This study aimed to investigate the impact of baseline 6 min walk test distance (6MWTD) on time to major cardiovascular (CV) events in heart failure with reduced ejection fraction (HFrEF) and its impact in clinically relevant subgroups. Methods and results In the WARCEF (Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction) trial, 6MWTD at baseline was available in 2102 HFrEF patients. Median follow‐up was 3.4 years. All‐cause death and heart failure hospitalization (HFH) exhibited a significant non‐linear relationship with 6MWTD (P = 0.023 and 0.032, respectively), whereas a significant association between 6MWTD and CV death was shown in a linear model [hazard ratio (HR) per 10 m increase, 0.989; P = 0.011]. In linear splines with the best cut‐off point at 200 m, the positive effect of a longer 6MWTD on all‐cause death and HFH was only observed for 6MWTD > 200 m (HR per 10 m increase, 0.987; P = 0.0036 and 0.986; P = 0.0022, respectively). The associations between 6MWTD and CV outcomes were consistent across clinical subgroups; for age, a significant relationship between 6MWTD and HFH was observed in patients ≥60 years (HR per 10 m increase, 0.98; P < 0.001), but not in patients <60 years (HR per 10 m increase, 1.00; P = 0.98; P = 0.02 for the interaction). Conclusions In HFrEF, 6MWTD is independently associated with all‐cause death, CV death, and HFH. 6MWTD of 200 m is the best cut‐off point for predicting these adverse events. The prognostic impact of 6MWTD for HFH was only observed in older patients.https://doi.org/10.1002/ehf2.130686 min walk testHeart failureCardiovascular eventPrognosis |
| spellingShingle | Kenji Matsumoto Yi Xiao Shunichi Homma John L.P. Thompson Richard Buchsbaum Kazato Ito Stefan D. Anker Min Qian Marco R. Di Tullio for the WARCEF Investigators Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial ESC Heart Failure 6 min walk test Heart failure Cardiovascular event Prognosis |
| title | Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial |
| title_full | Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial |
| title_fullStr | Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial |
| title_full_unstemmed | Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial |
| title_short | Prognostic impact of 6 min walk test distance in patients with systolic heart failure: insights from the WARCEF trial |
| title_sort | prognostic impact of 6 min walk test distance in patients with systolic heart failure insights from the warcef trial |
| topic | 6 min walk test Heart failure Cardiovascular event Prognosis |
| url | https://doi.org/10.1002/ehf2.13068 |
| work_keys_str_mv | AT kenjimatsumoto prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT yixiao prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT shunichihomma prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT johnlpthompson prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT richardbuchsbaum prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT kazatoito prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT stefandanker prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT minqian prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT marcorditullio prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial AT forthewarcefinvestigators prognosticimpactof6minwalktestdistanceinpatientswithsystolicheartfailureinsightsfromthewarceftrial |