Prognostic value of discharge heart rate in acute heart failure patients

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)...

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Detalles Bibliográficos
Autores: Rosa, Agra Bermejo, Domingo, Pascual-Figal, Francisco, Gude Sampedro, Delgado-Jiménez, Juan Francisco|||0000-0002-5401-8324, Vidal Pérez, Rafael|||0000-0001-9944-8363, Inés, Gómez Otero, Ferrero-Gregori, Andreu|||0000-0001-6492-2416, Jesús, Álvarez-García, Worner Diz, Fernando|||0000-0001-7993-7709, Jesús, Segovia, María Generosa, Crespo-Leiro, Cinca, Juan|||0000-0003-4819-4265, Fernández Avilés, Francisco|||0000-0001-5501-5275, Jose Ramón, Gónzalez-Juanatey
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:227661
Acceso en línea:https://ddd.uab.cat/record/227661
https://dx.doi.org/urn:doi:10.1016/j.ijcha.2019.100444
Access Level:acceso abierto
Palabra clave:Heart rate
Acute heart failure
Sinus rhythm
Atrial fibrillation
Mortality
Descripción
Sumario: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.

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