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Göteborgs universitets publikationer

Association of Heart Rate and Outcomes in a Broad Spectrum of Patients With Chronic Heart Failure: Results From the CHARM (Candesartan in Heart Failure: Assessment of Reduction in Mortality and morbidity) Program

Författare och institution:
D. Castagno (-); H. Skali (-); M. Takeuchi (-); Karl Swedberg (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); S. Yusuf (-); C. B. Granger (-); E. L. Michelson (-); M. A. Pfeffer (-); J. J. McMurray (-); S. D. Solomon (-)
Publicerad i:
Journal of the American College of Cardiology, 59 ( 20 ) s. 1785-1795
ISSN:
1558-3597
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2012
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
OBJECTIVES: The aim of this study was to explore the relationship between baseline resting heart rate and outcomes in patients with chronic heart failure (HF) according to baseline left ventricular ejection fraction (LVEF) and cardiac rhythm. BACKGROUND: Elevated resting heart rate is associated with worse outcomes in patients with HF and reduced LVEF. Whether this association is also found in patients with HF and preserved LVEF is uncertain, as is the predictive value of heart rate in patients in atrial fibrillation (AF). METHODS: Patients enrolled in the CHARM (Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity) Program were divided into groups by tertiles of baseline heart rate. Cox proportional hazard models were used to investigate the association between heart rate and pre-specified outcomes in the overall population as well as in subgroups defined according to LVEF (40%) and presence (or absence) of AF at baseline. RESULTS: After adjusting for predictors of poor prognosis, patients in the highest heart rate tertile had worse outcomes when compared with those in the lowest heart rate group (e.g., for the composite of cardiovascular death or HF hospital stay hazard ratio: 1.23, 95% confidence interval: 1.11 to 1.36, p < 0.001). The relationship between heart rate and outcomes was similar across LVEF categories and was not influenced by beta-blocker use (p value for interaction >0.10 for both endpoints). However, amongst patients in AF at baseline, heart rate had no predictive value (p value for interaction <0.001). CONCLUSIONS: Resting heart rate is an important predictor of outcome in patients with stable chronic HF without AF, regardless of LVEF or beta-blocker use.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin
Nyckelord:
atrial fibrillation; ejection fraction; heart failure; heart rate; prognosis
Postens nummer:
157921
Posten skapad:
2012-05-23 11:04
Posten ändrad:
2016-06-10 12:05

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