The relationship between heart rate and mortality of patients with acute coronary syndromes in the coronary intervention era

Xu, Tan; Zhan, Youqin; Xiong, Jianping; Lu, Nan; He, Zhuoqiao; Su, Xi; Tan, Xuerui

doi:10.1097/md.0000000000005371

Cited by 19 publications

(16 citation statements)

References 20 publications

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“…Unfortunately, the results from our study suggest that DP was not useful after HR and SBP were used to predict MACEs in ACS patients because the predictive value of DP was weakened after the model was adjusted for other haemodynamic parameters, such as HR. HR has been demonstrated as an independent risk factor of MACE events in ACS patients, as we have reviewed in a meta-analysis [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown that heart rate (HR) is also a risk factor for mortality and cardiovascular morbidity in patients with acute coronary syndrome (ACS) [ 2 ]. Recently, our meta-analysis concluded that elevated HR may increase the mortality of ACS patients in the percutaneous coronary intervention era, irrespective of admission, rest or discharge HR [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Double product reflects the association of heart rate with MACEs in acute coronary syndrome patients treated with percutaneous coronary intervention

Zhan

et al. 2017

BMC Cardiovasc Disord

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BackgroundThere is little information about the prognostic value of double product (DP) for acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). The aim of this study was to investigate whether DP reflects the predictive power of heart rate (HR) or systolic blood pressure (SBP) in ACS patients treated with PCI.MethodsA total of 7590 ACS patients who had undergone PCI, free from cardiac shock, were included. The follow-up duration was two years. The main adverse cardiovascular events (MACEs) included all-cause death, recurrent myocardial infarction and stroke.ResultsIn the unadjusted model, significantly higher rates of MACEs were recorded in the high DP group (relative risk 1.41, 95%CI 1.08 to 1.83, p = 0.012). However, in the full adjusted models, after including HR and SBP, the predictive value of DP was not significant (relative risk 0.86, 95%CI 0.55 to1.33, p = 0.499). The predictive value of HR for MACEs was statistically significant (relative risk 1.74, 95% CI 1.33–2.28, p < 0.001). It was worth noting that the history of hypertension was strongly associated with MACEs (relative risk 1.53, 95% CI 1.11–2.11, p = 0.009).ConclusionHigh DP is associated with MACEs for ACS patients treated with PCI. However, the predictive value of DP weakened when adjusted for HR. Therefore, we have shown that DP may reflect the predictive power of HR for ACS patients treated with PCI.Electronic supplementary materialThe online version of this article (10.1186/s12872-017-0714-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Double product reflects the association of heart rate with MACEs in acute coronary syndrome patients treated with percutaneous coronary intervention

Zhan

et al. 2017

BMC Cardiovasc Disord

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“…In the context of acute care, elevated HR is associated with increased mortality in patients with either primary heart diseases (e.g. acute coronary syndromes) 49 or systemic syndromes (e.g. sepsis).…”

Section: What Is Knownmentioning

confidence: 99%

Effect of ivabradine on major adverse cardiovascular events and mortality in critically ill patients: a systematic review and meta-analyses of randomised controlled trials with trial sequential analyses

Chen

Elia

Dunaiceva

et al. 2020

British Journal of Anaesthesia

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Background: Ivabradine lowers heart rate (HR) without affecting contractility or vascular tone. It is licensed for HR control in chronic heart diseases. We performed a systematic review and meta-analyses to examine whether ivabradine could decrease major adverse cardiovascular events (MACE) and mortality in critically ill patients. Methods: We searched Medline, Embase, Cochrane Library, and Web of Science for RCTs. Trial quality was assessed using the Cochrane risk of bias tool. Random-effects meta-analyses were performed if at least three trials or 100 patients were available. Results are reported as weighted mean difference (WMD), odds ratio (OR), and 95% confidence intervals (CIs). Trial sequential analyses were performed to estimate the sample size needed to reach definitive conclusions of efficacy or futility. Results: We included 13 RCTs (n¼1497 patients). We found no evidence of an impact of ivabradine on MACE (three RCTs, 819 patients; OR¼0.77; 95% CI, 0.53e1.11) or mortality (10 RCTs, 1356 patients; OR¼1.07; 95% CI, 0.63e1.82), but sample sizes were not reached to allow definitive conclusions. Compared with placebo or standard care, ivabradine reduced HR (eight RCTs, 464 patients; WMD, e9.5 beats min À1 ; 95% CI, e13.3 to e5.8). Risk of bradycardia was not different between ivabradine and control (five RCTs, 434 patients; OR¼1.2; 95% CI, 0.60e2.38). Risk of bias was overall high or unclear. Conclusions: Ivabradine reduces HR compared with placebo or standard care. The effect on MACE or mortality in acute care remains unclear. Further RCTs powered to detect changes in clinically relevant outcomes are warranted. Clinical trial registration: Prospero CRD42018086109.

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“…yaitu penurunan kondisi pada pasien kardiak, terjadinya kekambuhan miokard infark, dan stroke iskemia (Xu, et al, 2016).…”

Section: Mace (Major Adverse Cardiac Events)unclassified

The Differences of Correlation of the Timi, Grace, and Killip Risk Scores as Predictor Prognosis Patients With Non St-Elevation Myocard Infarction Acute Coronary Syndrome in Iccu Rsud DR.ISKAK Tulungagung

Anggraini

Wihastuti

Kartikawatiningsih

2019

JNSU

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Acute Coronary Syndromes is the leading cause of short-term and long -term mortality.An aggressive treatment approach has the potential to change the prognosis of patients with ACS, although its depends on risk factors. There are several risk scores such as Thrombholysis in Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), and Killip. The aim of this study is to analyse the differences of correlation of TIMI, GRACE, and Killip risk scoresas predictor Length Of Stay patientswith Non St-Elevation Myocard Infarction ACS.The method of this study utilized an analytic observational design with the cohort retrospective. The research was conducted at RSUD Dr.Iskak Tulungagung used 98 samples of medical records patient with NSTEMI ACS in the past 8 months (January-August 2017). The data collection techniques was completing risk score of TIMI, GRACE, and Killip and Length of Staypatient in ICCU ward. The results and analyse of Spearman Rank showed that TIMI has p = 0,000 r = 0.466, GRACE p = 0,000 r = 0.598, and Killip p = 0,000r = 0.441 (p < 0,05), so that it can be said that there was significant differences between the risk score of TIMI, GRACE and Killip as predictor prognosis patient with NSTEMI ACS. It can be concluded that the TIMI, GRACE and Killip risk scores have correlationas predictor prognosis patient with NSTEMI ACS,which is GRACE risk score has superior to TIMI and Killip.

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The relationship between heart rate and mortality of patients with acute coronary syndromes in the coronary intervention era

Cited by 19 publications

References 20 publications

Double product reflects the association of heart rate with MACEs in acute coronary syndrome patients treated with percutaneous coronary intervention

Double product reflects the association of heart rate with MACEs in acute coronary syndrome patients treated with percutaneous coronary intervention

Effect of ivabradine on major adverse cardiovascular events and mortality in critically ill patients: a systematic review and meta-analyses of randomised controlled trials with trial sequential analyses

The Differences of Correlation of the Timi, Grace, and Killip Risk Scores as Predictor Prognosis Patients With Non St-Elevation Myocard Infarction Acute Coronary Syndrome in Iccu Rsud DR.ISKAK Tulungagung

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