Key result
Elevated resting heart rate (≥ 76 bpm) independently predicted overall mortality in males <67 years (HR 2.5; 95% CI 1.5-4.2; p<0.001) and females ≥67 years, but not cardiac death in females.
Why the study?
Does elevated resting heart rate predict cardiac and total mortality in patients referred for coronary angiography?
Cohort (n=3,559)
No
Does elevated resting heart rate predict cardiac and total mortality in patients referred for coronary angiography?
Hazard Ratio: 2.5 (95% CI 1.5–4.2)
p-value: p=< 0.001
Elevated resting heart rate is an independent predictor of mortality in male patients and older female patients referred for coronary angiography, highlighting significant age and sex differences in its prognostic value.
Highlights age-sex differences for prognostication in angiography referrals; leaves open whether heart rate modification alters outcomes.
UNLABELLED: OBJECTIVE To evaluate the predictive value of resting heart rate (RHR) for cardiac and total mortality in a large population of patients referred for coronary angiography with an extended follow-up, stratified in four subpopulations according to gender and age (50th percentile corresponding to 67 years). METHODS: We studied 3559 subjects (2603 males, age: 66 ± 11 years, mean ± SD), obtaining patient data from the Institute electronic databank which saves demographic, clinical, instrumental and follow-up data of patients admitted to our department. RESULTS: During a mean follow-up period of 35 ± 25 months, 296 (8%) patients died; there were 173 (5%) cardiac deaths. In female patients irrespective of age, RHR (≥ 76 bpm, 75th percentile) did not appear predictive for cardiac death. In females, RHR was predictive for overall mortality after multivariate adjustment only in those aged ≥ 67 years (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1-2.8, p ≤ 0.05). In male patients aged < 67 years, RHR remained as an independent predictive factor for overall mortality at the multivariate analysis (HR 2.5, 95% CI 1.5-4.2, p < 0.001), and as an independent predictor for both cardiac mortality (HR 1.8, 95% CI 1.2-2.7, p < 0.01) and total mortality (HR 1.6, 95% CI 1.2-2.3, p < 0.01) in male patients over 67 years. CONCLUSION: The current study suggests that the prognostic importance of RHR may differ according to the patient's gender and age, suggesting significant differences in cardiovascular physiopathology between female and male patients.
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Vassalle et al. (2013) conducted a cohort in Coronary artery disease (referred for coronary angiography) (n=3,559). Elevated resting heart rate (≥ 76 bpm) vs. Lower resting heart rate (< 76 bpm) was evaluated on Overall mortality in males < 67 years (HR 2.5, 95% CI 1.5-4.2, p=< 0.001). Elevated resting heart rate (≥ 76 bpm) independently predicted overall mortality in males <67 years (HR 2.5; 95% CI 1.5-4.2; p<0.001) and females ≥67 years, but not cardiac death in females.
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