Abstract

Background

In acute coronary syndrome (ACS) patients there are mostly studies evaluating prognostic value of admission heart rate. We tried to understand the prognostic value of discharge heart rate in a spectrum of ACS patients.

Methods

A total of 473 consecutive ACS patients were included in the study. Forty-three (9.1%) of them were unstable angina pectoris, 268 (56.7%) were non-ST elevation myocardial infarction and 162 (34.2%) of them were ST elevation myocardial infarction patients. Discharge heart rates of the patients were recorded and the patients were followed-up for 1 year. The primary end-point was all-cause mortality.

Results

The mean age of the patients was 64 ± 12. The patients were divided into three subgroups according to discharge heart rates (<78, 78–89, ≥90 beats per minute). Patients with a higher discharge heart rate had higher serum troponin, glucose levels and higher admission heart rates, had lower ejection fraction values and had acute heart failure complication more frequently than the patients with a lower discharge heart rate. A total of 72(16%) patients died during 1 year follow-up. In multivariate logistic regression analysis, an increased discharge heart rate was independently associated with 1-month mortality after ACS, but it was not independently associated with 6-month or 1-year mortality after ACS. Every 1 bpm increase in discharge heart rate resulted in a significant increased risk of 8.2% in 1-month all-cause mortality.

Conclusion

Increased heart rate at discharge is an independent predictor of 1-month mortality in ACS patients. This relationship disappears after 1-month through 1-year follow-up.

中文翻译：

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出院心率增加可能与急性冠脉综合征后短期死亡率增加有关

摘要

背景

在急性冠状动脉综合征 (ACS) 患者中，大多数研究评估入院心率的预后价值。我们试图了解出院心率在一系列 ACS 患者中的预后价值。

方法

共有 473 名连续的 ACS 患者被纳入研究。其中不稳定型心绞痛43例（9.1%），非ST段抬高型心肌梗死268例（56.7%），ST段抬高型心肌梗死162例（34.2%）。记录患者出院心率，随访1年。主要终点是全因死亡率。

结果

患者的平均年龄为 64 ± 12 岁。根据出院心率（<78、78–89、≥90 次/分钟）将患者分为三个亚组。与出院心率较低的患者相比，出院心率较高的患者血清肌钙蛋白、葡萄糖水平较高，入院心率较高，射血分数较低，急性心力衰竭并发症发生率较高。共有 72 名 (16%) 患者在 1 年随访期间死亡。在多变量逻辑回归分析中，出院心率增加与 ACS 后 1 个月死亡率独立相关，但与 ACS 后 6 个月或 1 年死亡率无关。出院心率每增加 1 bpm 会导致 1 个月全因死亡率的风险显着增加 8.2%。

结论

出院时心率增加是 ACS 患者 1 个月死亡率的独立预测因子。这种关系在 1 个月到 1 年的随访后消失。