Predictive role of peak VO for short- and long-term major adverse cardiac events in patients with high cardiovascular risk.

BACKGROUND

The objective of this study was to assess the accuracy of VO measurements in predicting long-term major adverse cardiac events (MACEs) in patients with high cardiovascular risk.

METHODS

Based on a 10-year atherosclerotic cardiovascular disease risk score, 333 patients with high cardiovascular risk were included in this retrospective analysis. The study endpoint was MACEs, comprising all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction or stroke, and coronary revascularization. The study cohort was divided into two groups according to the frequency of MACE occurrence. Measurements of VO were assessed for the prediction of MACEs.

RESULTS

The best predictive accuracy for 1‑year MACEs was determined to be a VO max value of ≥ 20.3 mL/kg/min, with 60% specificity and 60% sensitivity (area under the curve [AUC]: 0.61; 95% confidence interval [CI]: 0.51-0.71; p < 0.001), and for 5‑year MACEs it was ≥ 19.9 mL/kg/min, with 69% specificity and 64% sensitivity (AUC: 0.69; 95% CI: 0.62-0.76; p < 0.001). Multivariable Cox regression analysis, after adjusting for univariable factors, showed that VO max was independently associated with both short- and long-term MACEs in patients at high cardiovascular risk (hazard ratio [HR]: 0.900, 95% CI: 0.858-0.943, p < 0.001).

CONCLUSION

According to the results of this pilot study, VO max can predict both short- and long-term MACEs in patients at high cardiovascular risk.