TY - JOUR
T1 - Prognostic value of discharge heart rate in acute heart failure patients :
T2 - More relevant in atrial fibrillation?
AU - Rosa, Agra Bermejo
AU - Domingo, Pascual-Figal
AU - Francisco, Gude Sampedro
AU - Juan, Delgado Jiménez
AU - Rafael, Vidal Pérez
AU - Inés, Gómez Otero
AU - Andreu, Ferrero-Gregori
AU - Jesús, Álvarez-García
AU - Fernando, Worner Diz
AU - Jesús, Segovia
AU - María Generosa, Crespo-Leiro
AU - Cinca, Juan
AU - Francisco, Fernández Avilés
AU - Jose Ramón, Gónzalez-Juanatey
PY - 2019
Y1 - 2019
N2 - The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes. We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission. The mean age of the study population was 72 ± 12 years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one year all-cause mortality (Relative risk (RR) = 1.182, confidence interval (CI) 95% 1.024-1.366, p = 0.022) in SR. In AF patients discharge HR was associated with one year all cause mortality (RR = 1.276, CI 95% 1.115-1.459, p ≤ 0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction. In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients.
AB - The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes. We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission. The mean age of the study population was 72 ± 12 years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one year all-cause mortality (Relative risk (RR) = 1.182, confidence interval (CI) 95% 1.024-1.366, p = 0.022) in SR. In AF patients discharge HR was associated with one year all cause mortality (RR = 1.276, CI 95% 1.115-1.459, p ≤ 0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction. In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients.
KW - Heart rate
KW - Acute heart failure
KW - Sinus rhythm
KW - Atrial fibrillation
KW - Mortality
U2 - 10.1016/j.ijcha.2019.100444
DO - 10.1016/j.ijcha.2019.100444
M3 - Article
C2 - 32140546
SN - 2352-9067
VL - 26
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
ER -
