Predictive role of peak VO₂ for short- and long-term major adverse cardiac events in patients with high cardiovascular risk

The objective of this study was to assess the accuracy of VO₂ measurements in predicting long-term major adverse cardiac events (MACEs) in patients with high cardiovascular risk.

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 VO₂ were assessed for the prediction of MACEs.

The best predictive accuracy for 1‑year MACEs was determined to be a VO₂ 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 VO₂ 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).

According to the results of this pilot study, VO₂ max can predict both short- and long-term MACEs in patients at high cardiovascular risk.