Improvements in walking speed reduce mortality in patients with cardiovascular disease during exercise-based secondary prevention: findings from the ITER registry

Aims To investigate associations between walking speed (WS) and mortality among patients with stable cardiovascular disease (CVD). Additionally, it sought to analyse the impact of a long-term exercise intervention on physical function by analysing the relationship between changes in WS and mortality over a decade of observation.Methods and results Of the 3328 patients included in the ITER registry (NCT05817305) between 1997 and 2023, 2858 (aged 65 +/- 11 years) were analysed. Walking speed was measured using the 1-km treadmill walking test (1k-TWT). Patients were initially categorized into tertiles based on baseline WS and subsequently divided into six categories by associating baseline WS with changes over time. Cox proportional hazard models were used to examine associations between WS, all-cause and disease-specific mortality, adjusting for demographic and clinical confounders. A total of 1031 patients died over a median follow-up of 11 years. Higher baseline WS was inversely associ...