Admission Heart Rate Is a Determinant of Effectiveness of Beta-Blockers in Acute Myocardial Infarction Patients

Okuno, Taishi; Aoki, Jiro; Tanabe, Kengo; Nakao, Kōichi; Kimura, Kazuo; Ako, Junya; Noguchi, Teruo; Yasuda, Satoshi; Suwa, Satoru; Fujimoto, Kazuteru; Nakama, Yasuharu; Morita, Takashi; Shimizu, Wataru; Saito, Yoshihiko; Hirohata, Atsushi; Morita, Yasuhiro; Inoue, Teruo; Okamura, Atsunori; Mano, Toshiaki; Hirata, Kazuhito; Shibata, Yoshisato; Owa, Mafumi; Tsujita, Kenichi; Funayama, Hiroshi; Kokubu, Nobuaki; Kozuma, Ken; Uemura, Shiro; Tobaru, Tetsuya; Saku, Keijiro; Ohshima, Shigeru; Nishimura, Kunihiro; Miyamoto, Yoshihiro; Ogawa, Hisao; Ishihara, Masaharu

doi:10.1253/circj.cj-18-0995

Cited by 8 publications

(6 citation statements)

References 37 publications

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“…As an independent risk factor of cardiovascular diseases, the increase of resting heart rate is positively associated with the mortality of cardiovascular events from AMI (18,19), which leads to the increase of myocardial oxygen consumption amount, the decrease in coronary artery perfusion, causes myocardial ischemia, an increase in the number of necrotic myocardial cells and the reduction of myocardial compliance, which could further cause the heart myocardial remodeling and cardiac function failure (20). Therefore, active clinical control of the resting heart rate has become one of the most important methods for treating AMI (21). Although β-blockers are clinically used to slow down the heart rate, effects such as negative conduction, negative muscle strength, and lower blood pressure, and side effects and contraindications all require consideration with the clinical application of these drugs (22), which limits its clinical application.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of ivabradine in the treatment of acute myocardial infarction: a systematic review and meta-analysis

Wang

Zhang²,

Chen³

et al. 2021

Ann Palliat Med

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Background: Cardiovascular diseases have become a prominent threat to public health and quality of life.In recent years, some studies have reported that ivabradine can improve the cardiac function and prognosis of patients with acute myocardial infarction (AMI). Methods: We searched China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Biomedical Literature (CBM), Chongqing Weipu Chinese Sci-tech Journal Database (VIP), PubMed, Cochrane Library, and EMBASE for randomized controlled trials (RCTs) of ivabradine in the treatment of AMI from January 1980 until December 2020. Each RCT was systematically reviewed. Results: A total of 7 RCTs with 658 patients were included. Compared with the control group, the heart rate [mean deviation (MD) =−9.20, 95% confidence interval (CI): −13.03 to −5.38, P<0.00001] and brain natriuretic peptide (BNP) (MD =−112.73, 95% CI: −186.12 to −39.35, P=0.003) of patients who received ivabradine combined with conventional standard treatment were significantly lower and left ventricular ejection fraction (LVEF) (MD =3.17, 95% CI: 2.12 to 4.23, P<0.00001) was significantly better. The difference in adverse events was not statistically significant [odds ratio (OR) =2.45, 95% CI: 0.92 to 6.55, P=0.07].Discussion: Ivabradine combined with β-blockers can reduce the resting heart rate and improve heart function in patients with AMI while not increasing adverse events. However, due to limitations in the number and quality of studies included, our conclusions need to be further confirmed by analyzing more studies.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of ivabradine in the treatment of acute myocardial infarction: a systematic review and meta-analysis

Wang

Zhang²,

Chen³

et al. 2021

Ann Palliat Med

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“…Zhang et al 6 conducted a study that revealed the potential of esmolol in attenuating lung injury and inflammation in rats with severe acute pancreatitis. Notably, compelling evidence suggests that effective control of a rapid heart rate can significantly improve the prognosis of patients afflicted with liver cirrhosis 16 , sepsis 12 , Marfan syndrome 17 , congestive heart failure 18 , and uncontrolled hypertension 19 . Given the potential clinical significance of heart rate management, our study contributes to the existing knowledge by establishing a research foundation for exploring the impact of heart rate control specifically in the context of acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Prolonged elevated heart rate and 90-Day mortality in acute pancreatitis

Xie,

Deng,

Zhang

et al. 2024

Sci Rep

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Prolonged elevated heart rate (peHR) is recognized as a risk factor for poor prognosis among critically ill patients. However, there is currently a lack of studies investigating the association between peHR and patients with acute pancreatitis. Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV) database was used to identify patients with acute pancreatitis. PeHR was defined as a heart rate exceeding 100 beats per minute for at least 11 out of 12 consecutive hours. Cox regression analysis was used to assess the association between peHR and the 90-Day mortality. A total of 364 patients (48.9%) experienced a peHR episode. The 90-day mortality was 25%. PeHR is an independent risk factor for 90-day mortality (HR, 1.98; 95% CI 1.53–2.56; P < 0.001). KM survival curves exhibited a significant decrease in the survival rate at 90 days among patients who experienced a peHR episode (P < 0.001, 84.5% vs. 65.1%). We revealed a significant association of peHR with decreased survival in a large cohort of ICU patients with acute pancreatitis.

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“…17) Admission HR was a determinant of effectiveness of beta-blockers for patients with AMI, and HR at discharge independently predicted long-term aortic outcomes in surgically treated patients with type A AAD. 18,19) However, the relationship between HR at admission and clinical outcomes in patients with AAD is unknown.…”

Section: Discussionmentioning

confidence: 99%

Admission Heart Rate and Mortality in Critically Ill Patients with Acute Aortic Dissection

et al. 2023

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The association between admission heart rate (HR) and the mortality of critically ill patients with acute aortic dissection (AAD) remains unclear.The data were extracted from the Medical Information Mart for Intensive Care (MIMIC-III) database. Cox regression models and Kaplan-Meier (KM) survival curve were used to explore the association between admission HR and 90-day, 1-year, and 3-year mortality in patients with AAD. Sensitivity analyses were conducted to assess potential bias.A total of 374 eligible AAD patients were included and divided in 4 groups according to admission HR (HR !70, 71-80, 81-90, and > 90 beats per minute (bpm)). The patients with AAD in the group with HR > 90 bpm had higher 90-day, 1-year, and 3-year mortality than those in the groups with HR !70, 71-80, and 81-90 bpm. After adjusting for age, sex, BMI, systolic blood pressure, diastolic blood pressure, SOFA score, SAPSII score, Stanford type, hypertension, coronary artery disease, liver disease, atrial fibrillation, valvular disease, intensive care unit mechanical ventilation, aortic surgery, and thoracic endovascular aortic repair, patients with admission HR > 90 bpm had a higher risk of 90-day, 1-year, and 3-year mortality [adjusted hazard ratio, 95% confidence interval, 5.14 (2.22-11.91) P < 0.001; 4.31 (2.10-8.84) P < 0.001; 3.01 (1.66-5.46) P < 0.001] than those with HR 81-90 bpm. The 90-day, 1-year, and 3-year mortality were similar among the groups with HR ! 70, 71-80, and 81-90 bpm.Admission HR > 90 bpm was independently associated with all-cause mortality in critically ill AAD patients, either type A or B aortic dissection.

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Admission Heart Rate Is a Determinant of Effectiveness of Beta-Blockers in Acute Myocardial Infarction Patients

Cited by 8 publications

References 37 publications

Effectiveness and safety of ivabradine in the treatment of acute myocardial infarction: a systematic review and meta-analysis

Effectiveness and safety of ivabradine in the treatment of acute myocardial infarction: a systematic review and meta-analysis

Prolonged elevated heart rate and 90-Day mortality in acute pancreatitis

Admission Heart Rate and Mortality in Critically Ill Patients with Acute Aortic Dissection

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