LONG-TERM PROGNOSTIC VALUE OF EXERCISE TESTING IN MEN AND WOMEN FROM THE CORONARY-ARTERY SURGERY STUDY (CASS) REGISTRY

Many prior studies involving a predominantly male population have demo nstrated the importance of exercise test results in determining the ou tcome of patients with coronary artery disease. The prognostic signifi cance of exercise testing in women is unknown. In our study, a total o f 3,086 men and 747 women underwent maximal treadmill exercise testing , coronary angiography, and were prospectively followed for vp to 16 y ears. They were divided into 3 groups (high, intermediate, and low ris k) on the basis of exercise testing. Sixteen-year survival based on ex ercise test groups ranged from 38% to 61% in men and from 44% to 79% i n women (p < 0.001). Among men, 12-year survival was enhanced by coron ary artery bypass surgery versus medical therapy in the high-risk subg roup (69% vs 55%, respectively, p = 0.0025), but the 2 therapies were similar in the intermediate- and low-risk sub-groups. Among women, nei ther medical nor surgical resulted in improved 12-year survival rates in any of the 3 subgroups, These results suggest that exercise testing is helpful in assessing long-term survival in men and women. However, only exercise testing in men could identify a high-risk subset whose survival was enhanced by coronary artery bypass graft surgery.