CHA2DS2-VASc score and exercise capacity of patients with coronary artery disease participating in cardiac rehabilitation programs

BACKGROUNDExercise based cardiac rehabilitation improves prognosis and quality of life in patients with coronary artery disease. We aimed to investigate whether the CHA2DS2-VASc score may be a predictor of improvement in exercise capacity in acute coronary syndrome (ACS) patients participating in a cardiac rehabilitation program. METHODSIncluded were patients following a hospital admission due to ACS and were subsequently referred for an exercise based cardiac rehabilitation during 2010–2015. Participants were divided into three groups of low (1–2), intermediate (3) and high (4≤) CHA2DS2-VASc score. Exercise capacity was evaluated by a treadmill stress test at baseline and following 9 months. The primary endpoint was the percent of patients who achieved at least 25% improvement in exercise capacity. RESULTSThe 597 patients included in the study had a mean age of 65.5±9.3 years and consisted of 22.5% women. The primary endpoint of at least 25% improvement in exercise capacity following 9 months of cardiac rehabilitation occurred more frequently in patients in the high CHA2DS2-VASc group compared to the intermediate and low CHA2DS2-VASc score groups (47.3, 29.9 and 36.1% in the high, intermediate and low CHA2DS2-VASc score groups respectively, P=0.002). CONCLUSIONThe CHA2DS2-VASc score may serve as a predictor of exercise capacity improvement. Its use for tailoring specific cardiac rehabilitation programs for ACS patients may yield further improvement in functional capacity and better utilization of resources.