Haskiah Feras, Shacham Yacov, Minha Saar, Rozenbaum Zach, Pereg David
aHadassah-Hebrew University Medical Centre, Jerusalem bDepartment of Cardiology, Tel Aviv Sourasky Medical Center cSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel dCardiology Department, Assaf-Harofeh Medical Center, Zerifin eDepartment of Cardiology, Meir Medical Center, Kfar Saba, Israel.
Coron Artery Dis. 2017 Dec;28(8):697-701. doi: 10.1097/MCA.0000000000000550.
Exercise 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.
Included 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.
The 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).
The 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.
基于运动的心脏康复可改善冠心病患者的预后和生活质量。我们旨在研究CHA2DS2-VASc评分是否可作为参与心脏康复计划的急性冠脉综合征（ACS）患者运动能力改善的预测指标。
纳入因ACS入院并于2010年至2015年期间随后被转诊至基于运动的心脏康复项目的患者。参与者被分为CHA2DS2-VASc评分低（1-2分）、中（3分）和高（4分及以上）三组。在基线和9个月后通过跑步机压力测试评估运动能力。主要终点是运动能力至少提高25%的患者百分比。
纳入研究的597例患者平均年龄为65.5±9.3岁，其中女性占22.5%。与CHA2DS2-VASc评分中、低分组相比，CHA2DS2-VASc评分高分组患者在心脏康复9个月后运动能力至少提高25%这一主要终点出现的频率更高（CHA2DS2-VASc评分高、中、低分组分别为47.3%、29.9%和36.1%，P=0.002）。
CHA2DS2-VASc评分可作为运动能力改善的预测指标。将其用于为ACS患者量身定制特定的心脏康复计划可能会进一步改善功能能力并更好地利用资源。
