BACKGROUND: Lower admission heart rate (HR) is known to predict favorable outcome in ST-elevation acute myocardial infarction. However, there are limited short-term and no long-term data available regarding the prediction value of the initial HR in patients with the full spectrum of acute coronary syndromes (ACS). In addition, it is unknown whether the HR obtained later during hospitalization for ACS (i.e., Day 2 or 3) remains prognostically valuable. HYPOTHESIS: The aim of this study was to investigate the utility of the initial and delayed HR in predicting outcome in patients with ACS. METHODS: We examined mortality at 30 days and 10 months in 10,267 patients with ACS enrolled in the oral glycoprotein IIb/IIIa inhibition with Orofiban in Patients with Unstable coronary Syndromes-Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 trial. Patients were stratified by HR and day from onset of ACS into the following groups: (1) HR < 60 beats/min, (2) HR 60-80 beats/min, (3) HR 80-100 beats/min, (4) HR > 100 beats/min; and HR obtained on (1) Day 1, (2) Day 2, and (3) Day 3. RESULTS: By univariate analysis, mortality at 30 days and at 10 months increased progressively with higher HR strata (1.4 vs. 1.6 vs. 2.3 vs. 5.6%, p < 0.001, and 2.6 vs. 4.2 vs. 6.5 vs. 11.8%, p < 0.001, respectively). Elevated HR remained associated with mortality irrespective of time from onset of ACS. CONCLUSIONS: Higher initial and delayed HR is highly predictive of higher short- and long-term mortality in patients with ACS. This is a simple marker that could be easily used in risk assessment.
BACKGROUND: Lower admission heart rate (HR) is known to predict favorable outcome in ST-elevation acute myocardial infarction. However, there are limited short-term and no long-term data available regarding the prediction value of the initial HR in patients with the full spectrum of acute coronary syndromes (ACS). In addition, it is unknown whether the HR obtained later during hospitalization for ACS (i.e., Day 2 or 3) remains prognostically valuable. HYPOTHESIS: The aim of this study was to investigate the utility of the initial and delayed HR in predicting outcome in patients with ACS. METHODS: We examined mortality at 30 days and 10 months in 10,267 patients with ACS enrolled in the oral glycoprotein IIb/IIIa inhibition with Orofiban in Patients with Unstable coronary Syndromes-Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 trial. Patients were stratified by HR and day from onset of ACS into the following groups: (1) HR < 60 beats/min, (2) HR 60-80 beats/min, (3) HR 80-100 beats/min, (4) HR > 100 beats/min; and HR obtained on (1) Day 1, (2) Day 2, and (3) Day 3. RESULTS: By univariate analysis, mortality at 30 days and at 10 months increased progressively with higher HR strata (1.4 vs. 1.6 vs. 2.3 vs. 5.6%, p < 0.001, and 2.6 vs. 4.2 vs. 6.5 vs. 11.8%, p < 0.001, respectively). Elevated HR remained associated with mortality irrespective of time from onset of ACS. CONCLUSIONS: Higher initial and delayed HR is highly predictive of higher short- and long-term mortality in patients with ACS. This is a simple marker that could be easily used in risk assessment.
Authors: Lorenzo Fácila; Pedro Morillas; Juan Quiles; Federico Soria; Alberto Cordero; Pilar Mazón; Manuel Anguita; Cándido Martín-Luengo; Jose Ramón Gonzalez-Juanatey; Vicente Bertomeu Journal: World J Cardiol Date: 2012-01-26
Authors: Bayasgalan Gombojav; Hansoo Park; Jong Il Kim; Young Seok Ju; Joohon Sung; Sung Il Cho; Mi Kyeong Lee; Heechoul Ohrr; Janchiv Radnaabazar; Jeong Sun Seo Journal: Exp Mol Med Date: 2008-10-31 Impact factor: 8.718
Authors: Seamus P Whelton; Ron Blankstein; Mouaz H Al-Mallah; Joao A C Lima; David A Bluemke; W Gregory Hundley; Joseph F Polak; Roger S Blumenthal; Khurram Nasir; Michael J Blaha Journal: Hypertension Date: 2013-07-08 Impact factor: 10.190
Authors: Wesley T O'Neal; Waqas T Qureshi; Suzanne E Judd; James F Meschia; Virginia J Howard; George Howard; Elsayed Z Soliman Journal: Int J Stroke Date: 2015-08-26 Impact factor: 5.266
Authors: A Perne; F P Schmidt; M Hochadel; E Giannitsis; H Darius; L S Maier; C Schmitt; G Heusch; T Voigtländer; H Mudra; T Gori; J Senges; T Münzel Journal: Herz Date: 2015-09-28 Impact factor: 1.443