September 30, 2009European Heart Journal
The association of admission heart rate and in-hospital cardiovascular events in patients with non-ST-segment elevation acute coronary syndromes: results from 135 164 patients in the CRUSADE quality improvement initiative
Why the study?
Does presenting heart rate predict in-hospital cardiovascular events in patients with NSTE-ACS?
Population
135,164 patients with non-ST-segment elevation acute coronary syndromes from the CRUSADE quality improvement…
Comparison
Presenting heart rate vs Reference heart rate of 60-69 b.p.m.
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
Presenting HR may refine in-hospital risk stratification in NSTE-ACS; leaves open whether extremes warrant targeted intervention.
Structured PICO
Does presenting heart rate predict in-hospital cardiovascular events in patients with NSTE-ACS?
P
Population
135,164 patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) from the CRUSADE quality improvement initiative. Key exclusion: patients with systolic BP < 90 mm Hg (n=4,030) to avoid confounding by cardiogenic shock.
I
Intervention
Presenting heart rate (evaluated in 10 beat increments)
C
Comparator
Reference heart rate of 60-69 b.p.m.
O
Outcome
Composite of in-hospital events: all-cause mortality, non-fatal re-infarction, and strokecomposite
In patients with NSTE-ACS, presenting heart rate has a J-shaped association with in-hospital cardiovascular events, indicating that both very low and high heart rates are important prognostic markers.
Cite This Study
Bangalore et al. (2009) studied this question.