Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes — results from the BASKET PROVE trial
| Autor: | Hannes Alber, Gregor Fahrni, Christoph Kaiser, Sune H. Pedersen, Jan Skov Jensen, Karl Erik Sandsten, Søren Galatius, Magnus T. Jensen, R. Soerensen, Matthias Pfisterer, Osmund Bertel, Hans Rickli, Stefano De Servi, Allan Iversen, Paul Erne, Marzena Zurek, Maria Wanitschek |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Population Percutaneous Coronary Intervention Heart Rate Internal medicine Heart rate medicine Humans Sinus rhythm In patient cardiovascular diseases Myocardial infarction Acute Coronary Syndrome education Aged education.field_of_study business.industry Hazard ratio Percutaneous coronary intervention Middle Aged Prognosis medicine.disease Patient Discharge Treatment Outcome Conventional PCI Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 168:3802-3806 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2013.06.034 |
| Popis: | Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI).Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction.A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p=0.006) for 60-69 bpm, 3.8 (1.2-11.9, p=0.022) for 70-79 bpm, 4.3 (1.2-15.6, p=0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p0.001) for90 bpm. For cardiovascular death/myocardial infarction, a discharge HR90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p0.001) compared to a HR60 bpm. No interaction was found for disease presentation, diabetes or betablocker use.In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. |
| Databáze: | OpenAIRE |
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