Predictive Value of the CHA₂DS₂-VASc Score on Exercise Capacity in Patients with Cardiovascular Disease

Cardiac rehabilitation (CR) improves exercise capacity and is strongly recommended in clinical guidelines. However, no established scoring system exists to predict improvements in exercise capacity following CR.

This study aimed to assess whether the CHA₂DS₂-VASc score could serve as a predictive scoring system for improvements in exercise capacity after CR.

Of the 99 patients with cardiovascular disease who participated in the hospital-based CR, those who were ineligible were excluded. The remaining patients were stratified into 2 groups based on the median CHA₂DS₂-VASc score. Changes in peak oxygen uptake (peak VO₂) and clinical parameters from baseline to follow-up were compared between the groups.

A total of 46 patients (median age, 74 years; 72% male) were stratified according to the median CHA₂DS₂-VASc score of 4. Patients in the high-score group (CHA₂DS₂-VASc score ⩾ 4) were older, more likely to be female, and had elevated B-type natriuretic peptide levels compared with those in the low-score group (CHA₂DS₂-VASc score <4). The prevalence of comorbidities was similar between the groups. The low-score group showed a significantly greater improvement in peak VO₂ from baseline to follow-up compared with that of the high-score group (2.8 [1.3-4.7] vs 0.4 [-1.0 to 2.4] mL/kg/min, P < 0.01). Spearman's rank correlation analysis showed a significant negative correlation between CHA₂DS₂-VASc scores and the change in peak VO₂ between baseline and follow-up (r = -0.37, P = .01). A CHA₂DS₂-VASc score <4 was independently associated with an increase in peak VO₂ (β = 0.50, 95% confidence interval 0.23-2.14, P = .01) in the multivariate analysis using multiple linear regression.

The CHA₂DS₂-VASc score may be a useful tool for predicting potential improvements in exercise capacity after CR.