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Prognostic significance of heart rate in hospitalized patients presenting with myocardial infarction

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Author(s): Lorenzo Fácila | Pedro Morillas | Juan Quiles | Federico Soria | Alberto Cordero | Pilar Mazón | Manuel Anguita | Cándido Martín-Luengo | Jose Ramón Gonzalez-Juanatey | Vicente Bertomeu | on behalf of the “The Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome” (PAMISCA) Investigators

Journal: World Journal of Cardiology
ISSN 1949-8462

Volume: 4;
Issue: 1;
Start page: 15;
Date: 2012;
Original page

Keywords: Heart rate | Myocardial infarction | Prognosis

ABSTRACT
AIM: To investigate the prognostic significance of resting heart rate in patients with acute coronary syndrome (ACS), independent of other known factors. METHODS: Patients 40 years of age or older who had been admitted with acute coronary syndrome (ACS) to one of the 94 hospitals participating in the Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary Syndrome (PAMISCA) study were included. Patients were divided into two groups based on their resting heart rate (HR ≥ or < 70 bpm). Complications were recording during a follow-up period of 1 year. RESULTS: There were 1054 ACS patients analyzed (43.5% with ST segment elevation and 56.5% without elevation). Mean age was 66.6 ± 11.7 years, 70.6% were male and 29.4% of subjects were female. During follow-up, more patients in the HR ≥ 70 bpm group were hospitalized for heart failure and they also had a higher mortality rate. In the multivariate analysis, a heart rate of ≥ 70 bpm was independently related to overall mortality during the follow-up period (hazard ratio 2.5; 95% confidence interval, 1.26-4.97, P = 0.009). CONCLUSION: A resting heart rate ≥ 70 bpm in patients who survive an ACS is an indicator of a high risk of suffering cardiovascular events during follow-up.

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