Abstract 63: Higher Exercise Capacity Predicts Lower Levels of Inflammation in Both Men and Women with Coronary Artery Disease

Abstract

Introduction: Metabolic equivalent (METS) estimates the amount of oxygen the body uses during physical activity and reflects cardiorespiratory fitness. Exercise capacity (measured in METS), peripheral white blood cell count (WBC) and microalbuminuria (urine microalbumin/creatinine ratio -MCR) are associated with cardiovascular morbidity and mortality. Monocytes are an initiating event in atherosclerosis and are a measure of inflammation as are WBC and MCR. Hypothesis: Higher exercise capacity is associated with lower levels of inflammation (WBC, monocyte count and MCR) in patients with coronary artery disease (CAD). Methods: 291 subjects with stable CAD underwent graded exercise treadmill stress testing with calculation of METS. WBC, monocyte count and MCR were measured. Multivariate linear regression modeling was employed to identify predictors of inflammation for the total group and then stratified by gender and diabetes status. Results: METS was inversely correlated with and the best predictor of WBC, monocyte count and MCR for the total group and for men and women although age was slightly better than METS for WBC in men (see Table). When stratified by diabetes status, METS was inversely correlated with and the best predictor of monocyte count and MCR in non-diabetics whereas in diabetics, BMI was the best predictor. METS was significantly inversely correlated with WBC in diabetics and non-diabetics although age was slightly better in non-diabetics. Conclusions: Higher exercise capacity may have cardiovascular protective effects in patients with CAD through an anti-inflammatory effect as reflected in the lower levels of peripheral WBC, monocytes and microalbuminuria. Our findings suggest that exercise capacity could be a measure of chronic inflammation in patients with CAD and support the importance of exercise training in improving inflammation. The less pronounced effect of METS on monocyte count and MCR in diabetics could be due to other factors affecting inflammation in diabetics.