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In this issue of the Journal of the American College of Cardiology, Kokkinos et al5 studied the relationship of both a single CRF value, and change in CRF, with all-cause mortality in a large (n 1⁄4 93,060) sample from the ETHOS (Exercise Testing and Health Outcomes Study) cohort. In this cohort, CRF was estimated as the peak metabolic equivalents (METs) derived from the peak speed and grade obtained on a treadmill exercise test. The findings from the single measure of CRF showed, compared with the low-CRF group (w5 METs), reductions in mortality rate across each higher-CRF group in both those with cardiovascular disease (CVD) and those without CVD. However, their major finding was the powerful impact change in CRF had on changes in all-cause mortality; confirming and extending reports from 2 previous studies that used directly measured CRF from cardiopulmonary exercise testing, albeit in much smaller cohorts.


Originally published Journal of the American College of Cardiology