Abstract | BACKGROUND: METHODS: We analyzed the relationship between heart rate measurements and a range of adverse cardiovascular outcomes, including hospitalization for worsening heart failure, in the pooled placebo-treated patients from the morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction (BEAUTIFUL) trial and Systolic Heart failure treatment with the If inhibitor ivabradine (SHIFT) Trial, using standard and time-varying covariate Cox proportional hazards models. By adjusting for other prognostic factors, models were fitted for baseline heart rate alone or for time-updated heart rate (latest heart rate) alone or corrected for baseline heart rate or for immediate previous time-updated heart rate. RESULTS: Baseline heart rate was strongly associated with all outcomes apart from hospitalization for myocardial infarction. Time-updated heart rate increased the strengths of associations for all outcomes. Adjustment for baseline heart rate or immediate previous time-updated heart rate modestly reduced the prognostic importance of time-updated heart rate. For hospitalization for worsening heart failure, each 5 beats/min increase in baseline heart rate and time-updated heart rate was associated with a 15% (95% confidence interval, 12-18) and 22% (confidence interval, 19-40) increase in risk, respectively. Even after correction, the prognostic value of time-updated heart rate remained greater. CONCLUSIONS:
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Authors | Victoria Hamill, Ian Ford, Kim Fox, Michael Böhm, Jeffrey S Borer, Roberto Ferrari, Michel Komajda, Philippe Gabriel Steg, Luigi Tavazzi, Michal Tendera, Karl Swedberg |
Journal | The American journal of medicine
(Am J Med)
Vol. 128
Issue 10
Pg. 1102-1108.e6
(Oct 2015)
ISSN: 1555-7162 [Electronic] United States |
PMID | 26044936
(Publication Type: Evaluation Study, Journal Article)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Female
- Heart Failure
(diagnosis, etiology, mortality)
- Heart Rate
- Hospitalization
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(diagnosis, etiology, mortality)
- Prognosis
- Proportional Hazards Models
- Time Factors
- Ventricular Dysfunction, Left
(complications, mortality, physiopathology)
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