015 Impact of discharge heart rate on 30 day mortality in patients with acute myocardial infarction - 07/07/11
Résumé |
Background |
In patients with acute myocardial infarction (MI), beta-blockers are recommended and contribute to control the heart rate (HR). The factors associated with HR and outcome of patients discharged with HR>70 beats per minute (bpm) is poorly documented.
Methods |
Prospective registry including patients with acute MI. Recorded variables corresponded to the CARDS dataset. The proportion of patients discharged with HR>70bpm was assessed. Multivariate regression was used to determine factors associated with HR at discharge and logistic regression was used to determine the prognostic value of high HR at discharge on 30 day mortality.
Results |
Among the 837 patients, 592 survived and were discharged with a beta blocker. Discharge HR was ≤70bpm in 61% when a betablocker was given and in 31% without beta blocker (p<0.001). Discharge HR was associated with older age, admission HR, admission systolic blood pressure, BNP level, diabetes, use of beta blockers and ACEI. Patients discharged with HR>70bpm (n=227, 39%) had a threefold higher mortality as compared with those with HR ≤70 (figure). Multivariate analysis showed that a HR ≥70 at discharge was an independent predictor of 30 day mortality on top of the GRACE risk score and use of beta blockers.
Conclusions |
Among patients discharged after acute MI, those with HR>70 have higher 30 day mortality, independently of the GRACE risk score and use of beta blockers.
Mortality by discharge heart rate
Mortality by discharge heart rateLe texte complet de cet article est disponible en PDF.
Vol 3 - N° 1
P. 5 - janvier 2011 Retour au numéro
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