Key result
Resting heart rate ≥84 beats/min was associated with increased all-cause mortality compared to <66 beats/min in CAD patients after PCI (HR 1.987; 95% CI 1.344-2.937; P=0.001).
Why the study?
The relationship between heart rate in CAD patients undergoing PCI and long-term outcomes over up to 10 years of follow-up had not been investigated.
Does higher resting heart rate predict adverse long-term outcomes in CAD patients who underwent PCI?
Cohort (n=6,049)
Does higher resting heart rate predict adverse long-term outcomes in CAD patients who underwent PCI?
Elevated resting heart rate is an independent predictor of long-term all-cause and cardiac mortality in CAD patients following PCI.
Higher resting heart rate signals elevated long-term risk post-PCI; extends shorter prior observations but leaves causal role and practice change open pending prospective trials.
Background. The relationship between heart rate in CAD patients who underwent percutaneous coronary intervention (PCI) and had long-term outcomes over up to 10 years of follow-up has not been investigated. Methods. All patients were from the CORFCHD-PCI, a retrospective cohort study that included a total of 6050 CAD patients who underwent PCI from January 2008 to December 2016. One patient was excluded due to a lack of heart rate data. Ultimately, 6049 patients were enrolled. The primary outcome was long-term mortality after PCI. Results. Patients were divided into 5 groups according to heart rate quintiles: 1st quintile (heart rate <66 beats/min; n=1123 ), 2nd quintile (heart rate ≥66 beats/min to 72 beats/min; n=1010 ), 3rd quintile (heart rate ≥72 beats/min to 78 beats/min; n=1442 ), 4th quintile (heart rate ≥78 beats/min to 84 beats/min; n=1211 ), and 5th quintile (heart rate ≥84 beats/min; n=1263 ). After multivariate Cox regression analyses, the respective risks of ACM, CM, and MACEs were increased 79.1% (hazard risk (HR) = 1.791, 95% CI: 1.207–2.657, P=0.004 ), 56.9% (HR = 1.569, 95% CI: 1.019–2.416, P=0.041 ), and 25.5% (HR = 1.255, 95% CI: 0.990–1.590, P=0.060 ) in the 4th quintile and 98.7% (HR = 1.987, 95% CI: 1.344–2.937, P=0.001 ), 98.8% (HR = 1.988, 95% CI: 1.310–3.016, P<0.001 ), and 0.36.1% (HR = 1.361, 95% CI: 1.071–1.730, P=0.012 ) in the 5th quintile compared with those in the 1st quintile. Patients with a heart rate of ≥80 beats/min had 89.4%, 115.2%, and 39.1% increased risk of ACM, CM, and MACEs, respectively, compared to those patients with a heart rate of <80 beats/min. Conclusion. The present study indicated that the resting heart rate is an independent predictor of adverse long-term outcomes in CAD patients who underwent PCI.
No takes yet. Share an insight, caveat, or question.
Zheng et al. (2019) conducted a cohort in Coronary artery disease (CAD) post-percutaneous coronary intervention (PCI) (n=6,049). Resting heart rate ≥84 beats/min (5th quintile) vs. Resting heart rate <66 beats/min (1st quintile) was evaluated on Long-term all-cause mortality after PCI (HR 1.987, 95% CI 1.344-2.937, p=0.001). Resting heart rate ≥84 beats/min was associated with increased all-cause mortality compared to <66 beats/min in CAD patients after PCI (HR 1.987; 95% CI 1.344-2.937; P=0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: