The Use of the CHA2DS2-VASc Score in Patients with Coronary Artery Disease Participating in a Cardiac Rehabilitation Program
DOI:
https://doi.org/10.25759/spmfr.450Keywords:
Acute Coronary Syndrome/rehabilitation, Cardiac Rehabilitation, Coronary Artery Disease/ rehabilitationAbstract
Introduction: Exercise based cardiac rehabilitation (CR) improves prognosis and quality of life in patients with coronary artery disease.CHA2DS2-VASc score stratifies the cardiovascular risk of patients given the presence of heart failure, hypertension, age over 75 years old, diabetes mellitus, previous cerebrovascular or embolic events, and vascular disease. We aimed to investigate whether the CHA2DS2-VASc score may be a predictor of improvement in exercise capacity in acute coronary syndrome patients participating in a CR program.
Material and Methods: This study included 69 patients with coronary artery disease referred for CR treatment. As inclusion criteria, patients should have a history of previous hospitalization for acute myocardial infarction. The patients were divided in three groups according to the CHA2DS2- VASc score: low risk (1-2), intermediate risk (3) and high risk (≥4). Functional exercise capacity was assessed through two treadmill stress tests performed at baseline and at 12 weeks. As a comparative value between patients and between tests, we considered the metabolic equivalents (METs) spent per test to evaluate exercise adaptation.
Results: There was a statistically significant difference between the METs spent in the first and last cardiac stress tests for all groups. As for the evolution in treadmill stress tests, low-risk patients increased from an average of 10.43 METs to 12.44; moderate risk patients progressed from 9.33 to 10.85 METs and high-risk patients had an initial average of 8.46 METs and of 10.74 METs at 12 weeks. When we compared the 3 groups of patients, we found that patients with high cardiovascular risk had lower functional capacity in the first cardiac stress test (p=0.009) and in the second one (p=0.011). There was a negative correlation of -0.451 between the result obtained in the first cardiac stress teste and the classification using the CHA2DS2-VASc scale.
Conclusion: CHA2DS2-VASc score may be considered as a readily available predictor of exercise capacity improvement. It might be useful for tailoring specific CR and for better resource allocation.
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