Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?
Aims: 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...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-02-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S235290671930171X |
| _version_ | 1811268557975060480 |
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| author | Agra Bermejo Rosa Pascual-Figal Domingo Gude Sampedro Francisco Delgado Jiménez Juan Vidal Pérez Rafael Gómez Otero Inés Ferrero-Gregori Andreu Álvarez-García Jesús Worner Diz Fernando Segovia Jesús Crespo-Leiro María Generosa Cinca Cuscullol Juan Fernández Avilés Francisco Gónzalez-Juanatey Jose Ramón |
| author_facet | Agra Bermejo Rosa Pascual-Figal Domingo Gude Sampedro Francisco Delgado Jiménez Juan Vidal Pérez Rafael Gómez Otero Inés Ferrero-Gregori Andreu Álvarez-García Jesús Worner Diz Fernando Segovia Jesús Crespo-Leiro María Generosa Cinca Cuscullol Juan Fernández Avilés Francisco Gónzalez-Juanatey Jose Ramón |
| author_sort | Agra Bermejo Rosa |
| collection | DOAJ |
| description | Aims: 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. Methods: 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. Results: 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. Conclusions: In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients. Keywords: Heart rate, Acute heart failure, Sinus rhythm, Atrial fibrillation, Mortality |
| first_indexed | 2024-04-12T21:24:19Z |
| format | Article |
| id | doaj.art-13de09d7ae8641f784a40ebc66831002 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-12T21:24:19Z |
| publishDate | 2020-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-13de09d7ae8641f784a40ebc668310022022-12-22T03:16:12ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672020-02-0126Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?Agra Bermejo Rosa0Pascual-Figal Domingo1Gude Sampedro Francisco2Delgado Jiménez Juan3Vidal Pérez Rafael4Gómez Otero Inés5Ferrero-Gregori Andreu6Álvarez-García Jesús7Worner Diz Fernando8Segovia Jesús9Crespo-Leiro María Generosa10Cinca Cuscullol Juan11Fernández Avilés Francisco12Gónzalez-Juanatey Jose Ramón13Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Corresponding author at: Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain. CIBERCV, Travesía da Choupana s/n, Santiago de Compostela, 15706 A Coruña, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, CIBERCV, Murcia, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Clinical Epidemiology Unit, Hospital Clinico Universitario de Santiago, Santiago de Compostela, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, SpainCardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), SpainCardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, SpainServicio de Cardiologia, Hospital Arnau de Vilanova, Lleida, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servico de Cardiologia, Hospital Puerta de Hierro, Majadahonda, Madrid, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Complexo Hospitalario Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña (UDC), A Coruña, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Cardiology Department, University Hospital Gregorio Marañón, Madrid, SpainCardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226 - CB16/11/00420), SpainAims: 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. Methods: 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. Results: 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. Conclusions: In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients. Keywords: Heart rate, Acute heart failure, Sinus rhythm, Atrial fibrillation, Mortalityhttp://www.sciencedirect.com/science/article/pii/S235290671930171X |
| spellingShingle | Agra Bermejo Rosa Pascual-Figal Domingo Gude Sampedro Francisco Delgado Jiménez Juan Vidal Pérez Rafael Gómez Otero Inés Ferrero-Gregori Andreu Álvarez-García Jesús Worner Diz Fernando Segovia Jesús Crespo-Leiro María Generosa Cinca Cuscullol Juan Fernández Avilés Francisco Gónzalez-Juanatey Jose Ramón Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? International Journal of Cardiology: Heart & Vasculature |
| title | Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? |
| title_full | Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? |
| title_fullStr | Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? |
| title_full_unstemmed | Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? |
| title_short | Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation? |
| title_sort | prognostic value of discharge heart rate in acute heart failure patients more relevant in atrial fibrillation |
| url | http://www.sciencedirect.com/science/article/pii/S235290671930171X |
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