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Jensen, M.T.* ; Pereira, M.* ; Araujo, C.* ; Malmivaara, A.* ; Ferrieres, J.* ; Dégano, I.R.* ; Kirchberger, I. ; Farmakis, D.* ; Garel, P.* ; Torre, M.* ; Marrugat, J.* ; Azevedo, A.*

Heart rate at admission is a predictor of in-hospital mortality in patients with acute coronary syndromes: Results from 58 European hospitals: The European Hospital Benchmarking by Outcomes in acute coronary syndrome Processes study.

Eur. Heart J. Acute Cardiovasc. Care 7, 149-157 (2018)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Aims: The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS).Methods: Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain). Cardiogenic shock patients were excluded. Associations between heart rate at admission in categories of 10 beats per min (bpm) and in-hospital mortality were estimated by logistic regression in crude models and adjusting for age, sex, obesity, smoking, hypertension, diabetes, known heart failure, renal failure, previous stroke and ischaemic heart disease. In total 10,374 patients were included.Results: In both STEMI and NSTE-ACS patients, a U-shaped relationship between admission heart rate and in-hospital mortality was found. The lowest risk was observed for heart rates between 70-79 bpm in STEMI and 60-69 bpm in NSTE-ACS; risk of mortality progressively increased with lower or higher heart rates. In multivariable models, the relationship persisted but was significant only for heart rates >80 bpm. A similar relationship was present in both patients with or without diabetes, above or below age 75 years, and irrespective of the presence of atrial fibrillation or use of beta-blockers.Conclusion: Heart rate at admission is significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS. ACS patients with admission heart rate above 80 bpm are at highest risk of in-hospital mortality.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Heart Rate ; Acute Coronary Syndrome ; Non-st-segment Elevation Acute Coronary Syndrome ; St-segment Elevation Myocardial Infarction ; Mortality; Acute Myocardial-infarction; Global Registry; Artery-disease; Risk-factor; Events; Intervention; Association; Management; Discharge; Trial
Language
Publication Year 2018
HGF-reported in Year 2018
ISSN (print) / ISBN 2048-8734
e-ISSN 2048-8726
Journal European heart journal - acute cardiovascular care
Quellenangaben Volume: 7, Issue: 2, Pages: 149-157 Article Number: , Supplement: ,
Publisher Sage
Publishing Place London [u.a.]
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
POF-Topic(s) 30202 - Environmental Health
Research field(s) Genetics and Epidemiology
PSP Element(s) G-504000-006
DOI 10.1177/2048872616672077
WOS ID WOS:000429799200007
Scopus ID 85051032797
PubMed ID 27694532
Erfassungsdatum 2018-05-17
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