The Relationship Between Heart Rate and Mortality Risk in Patients With Acute Aortic Dissection: A Meta-Analysis

Background: Acute aortic dissection (AAD) is a rare but life-threatening disease, and its rapid and correct diagnosis is important. Heart rate (HR) is a risk factor for death in patients with AAD, but their relationship remains unknown. This meta-analysis aimed to evaluate whether there was a significant correlation between HR and AAD mortality risk. Methods: By searching PubMed, Embase, and Web of Science databases, the studies reporting the correlation between HR and AAD were obtained, and their methodological quality was evaluated. Relative risk (RR) with 95% confidence interval (CI) was used as the effect size. Subgroup analysis, sensitivity analysis, and publication bias test (Egger’s test and funnel chart) were used to find the source of heterogeneity and evaluate the stability of the results. Results: Ten studies enrolling >4000 patients were included. Increased HR was positively correlated with increased AAD mortality risk (RR [95% CI] = 1.04 [1.01–1.07], p = 0.006). There was significant statistical heterogeneity among the included studies. The timing of HR monitoring, AAD type, and follow-up time were sources of heterogeneity. Sensitivity analysis showed that the combined results were stable. There was a significant publication bias in the included studies; however, the shear-fill method showed that the publication bias had little effect on the combined results (RR [95% CI] = 1.038 [1.010–1.066], p = 0.008). Conclusions: There was a positive relationship between increased HR and increased AAD mortality.