Purpose: To investigate the association between walking speed (WS) and mortality in cardiac patients with type 2 diabetes (T2D) undergoing a secondary prevention program. Methods: This observational study analyzed data from 490 patients with T2D (mean age 67±9 years) enrolled in the ITER registry (1998–2023). WS was assessed at baseline through the 1-km treadmill walking test (1km-TWT) and used to stratify patients into tertiles (Slower, Medium, Faster). Cox proportional hazard models were applied to assess associations between WS and all-cause and cardiovascular mortality, adjusting for demographic and clinical variables. A sensitivity analysis excluded deaths within the first 3 years of follow-up. Results: Over a median follow-up of 11 years, 205 patients died. Higher baseline WS was inversely associated with mortality. Compared to the Slower group, Medium (HR 0.46, 95% CI 0.33–0.62) and Faster (HR 0.59, 95% CI 0.41–0.80) walkers showed significantly lower all-cause mortality. Cardiovascular mortality was similarly reduced for Medium (HR 0.31, 95% CI 0.19–0.49) and Faster (HR 0.31, 95% CI 0.18–0.56) groups. Each 1 km/h increase in WS was associated with a 24% lower risk of all-cause mortality and a 42% lower risk of cardiovascular mortality. These associations were confirmed in the sensitivity analysis. Conclusions: Walking speed, as measured by the 1km-TWT, is a strong and independent predictor of mortality in cardiac patients with T2D. The test provides a simple and effective tool for evaluating functional status and guiding exercise-based interventions. These findings reinforce the role of physical activity promotion in long-term cardiovascular disease management and support the integration of functional assessments into secondary prevention strategies.
WALKING SPEED AND MORTALITY IN CARDIAC PATIENTS WITH TYPE 2 DIABETES: A 25-YEAR FOLLOW-UP STUDY
V. Zerbini;T. Piva;A. Raisi;E. Menegatti;G. Mazzoni;G. Grazzi;S. Mandini
2026
Abstract
Purpose: To investigate the association between walking speed (WS) and mortality in cardiac patients with type 2 diabetes (T2D) undergoing a secondary prevention program. Methods: This observational study analyzed data from 490 patients with T2D (mean age 67±9 years) enrolled in the ITER registry (1998–2023). WS was assessed at baseline through the 1-km treadmill walking test (1km-TWT) and used to stratify patients into tertiles (Slower, Medium, Faster). Cox proportional hazard models were applied to assess associations between WS and all-cause and cardiovascular mortality, adjusting for demographic and clinical variables. A sensitivity analysis excluded deaths within the first 3 years of follow-up. Results: Over a median follow-up of 11 years, 205 patients died. Higher baseline WS was inversely associated with mortality. Compared to the Slower group, Medium (HR 0.46, 95% CI 0.33–0.62) and Faster (HR 0.59, 95% CI 0.41–0.80) walkers showed significantly lower all-cause mortality. Cardiovascular mortality was similarly reduced for Medium (HR 0.31, 95% CI 0.19–0.49) and Faster (HR 0.31, 95% CI 0.18–0.56) groups. Each 1 km/h increase in WS was associated with a 24% lower risk of all-cause mortality and a 42% lower risk of cardiovascular mortality. These associations were confirmed in the sensitivity analysis. Conclusions: Walking speed, as measured by the 1km-TWT, is a strong and independent predictor of mortality in cardiac patients with T2D. The test provides a simple and effective tool for evaluating functional status and guiding exercise-based interventions. These findings reinforce the role of physical activity promotion in long-term cardiovascular disease management and support the integration of functional assessments into secondary prevention strategies.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
