Every 1 bpm increase in admission heart rate was associated with a 3.3% increased risk of adverse in-hospital cardiovascular events in STEMI patients undergoing primary PCI (OR 1.033).
Observational (n=309)
No
Does elevated admission or 24-hour heart rate predict adverse in-hospital cardiovascular outcomes in patients with STEMI undergoing primary PCI?
Elevated admission and 24-hour heart rates are independent predictors of adverse in-hospital cardiovascular events, predominantly acute heart failure, in patients with STEMI undergoing primary PCI.
Effect estimate: OR 1.033 (95% CI 1.008-1.060)
p-value: p=<0.05
Abstract Background Heart rate (HR) plays a central role in cardiac physiology and has been closely associated with major cardiovascular (CV) outcomes, including heart failure, ischemic heart disease, and cardiovascular mortality. However, whether HR can serve as an early predictor of in-hospital outcomes among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains unclear. This study aimed to evaluate the associations between heart rate at first medical contact (FHR), at hospital admission (AHR), and at 24 h post-admission (24 h) with adverse in-hospital outcomes. Methods This retrospective single-center observational study included 309 consecutive patients with STEMI who underwent PPCI between September 2018 and December 2020 at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Associations between the three HR measurements and in-hospital adverse cardiovascular events were analyzed using binary logistic regression models. Both crude models and models adjusted for conventional risk factors, biomarkers, and treatment variables were assessed. Results Both AHR and 24 h were positively associated with in-hospital CV events, predominantly acute heart failure ( P < 0.05), which were predominantly driven by acute heart failure. After adjusting for potential confounders, the odds of having in-hospital CV events were significantly enhanced by an increase in AHR and 24 h (odds ratio OR: 1.033, 95% confidence intervals CI: 1.008–1.060; OR: 1.037, 95% CI: 1.003–1.071, respectively). Additionally, every 5 bpm increase in AHR and 24 h was associated with an 18.6% and a 19.8% increased risk of in-hospital CV events, respectively. In contrast, FHR showed limited predictive value for such events. Conclusion Among STEMI patients undergoing PPCI, elevated admission and 24-hour heart rates are significantly associated with adverse in-hospital cardiovascular outcomes. Admission heart rate, in particular, may serve as a simple and reliable prognostic indicator for identifying patients at increased short-term risk.
Cui et al. (Mon,) conducted a observational in ST-segment elevation myocardial infarction (STEMI) (n=309). Admission heart rate (AHR) vs. Lower admission heart rate was evaluated on Adverse in-hospital cardiovascular events (acute heart failure, stroke, cardiovascular death, and non-cardiac death) (OR 1.033, 95% CI 1.008-1.060, p=<0.05). Every 1 bpm increase in admission heart rate was associated with a 3.3% increased risk of adverse in-hospital cardiovascular events in STEMI patients undergoing primary PCI (OR 1.033).