Impact of VO2peak on the Clinical Outcomes of Older Patients With Coronary Heart Disease in China

Abstract

Purpose: The aim of this study was to explore the role of cardiopulmonary exercise test parameters, especially peak oxygen uptake (VO2peak), in predicting the incidence of adverse cardiovascular events in older Chinese patients with coronary heart disease (CHD). Methods: Older patients with CHD who underwent cycle ergometer cardiopulmonary exercise test at the Cardiac Rehabilitation Clinic of Chinese PLA General Hospital from July 1, 2015 to January 31, 2020 were enrolled. The follow-up intervals were 6 mo. Cox regression was used to analyze the relationship between VO2peak and adverse cardiovascular events. Restricted cubic splines and subgroup analyses were used to observe the relationship between VO2peak and the hazard ratio (HR) of the primary end point event (PEE), which included a composite of all-cause death, nonfatal recurrent myocardial infarction, unscheduled revascularization, and stroke. The composite end point event was the PEE combined with cardiac rehospitalization. Results: A total of 1223 participants (mean age 68 ± 5 yr) were included. Median follow-up was 68 mo. Mean VO2peak was 16.5 ± 4.0 mL/kg/min, and VO2peak was an independent predictor of the PEE (HR = 0.929; 95% CI, 0.891-0.970; P = .001). This association was further validated by restricted cubic spline and subgroup analyses. Peak oxygen uptake was also an independent risk factor for the composite end point event (HR = 0.968; 95% CI, 0.941-0.996; P = .025). Conclusion: In conclusion, VO2peak is an independent risk factor for adverse cardiovascular events in older Chinese patients with CHD, and more optimal therapy should be recommended to patients with lower VO2peak.