Association of Heart Rate at Hospital Discharge With Mortality and Hospitalizations in Patients With Heart Failure

Habal, Marlena V.; Liu, Peter P.; Austin, Peter C.; Ross, Heather J.; Newton, Gary E.; Wang, Xuesong; Tu, Jack V.; Lee, Douglas S.

doi:10.1161/circheartfailure.113.000429

Cited by 44 publications

(36 citation statements)

References 27 publications

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“…30 Recently more and more attention is being paid to the problem of hospitalization due to CHF decompensation, which means that identifying factors that affect its occurrence is very important. Reports of found new variables associated with hospitalization have been published, such as heart rate 31 , which was not a factor influencing hospitalization in the present study. This was probably due to the study population undergoing optimal treatment that resulted in satisfactory heart rates.…”

Section: Discussionsupporting

confidence: 42%

Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction

Wojtczak-Soska¹,

Sakowicz²,

Pietrucha³

et al. 2017

Adv Clin Exp Med

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Section: Discussionsupporting

confidence: 42%

Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction

Wojtczak-Soska¹,

Sakowicz²,

Pietrucha³

et al. 2017

Adv Clin Exp Med

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“…These data underline again the importance of heart rate control in HF. In patients surviving the acute HF phase, higher heart rate at discharge but not at admission emerged as a potent predictor of 30-day mortality in the study of Habal et al Interestingly, this trend reached significance at heart rates above 90 bpm, a cut-off close to ours [7]. However, the impact of heart rate at admission on in-hospital mortality was not examined in that study.…”

Section: Heart Rate and Outcome In Hfmentioning

confidence: 71%

“…In acute non-arrhythmic HF, little is known about the impact of elevated heart rate on in-hospital outcome [6]. However, higher heart rate at hospital discharge in patients with HF has been associated with greater risk of all-cause and cardiovascular mortality up to 1-year follow-up, and elevated risk of 30-day readmission for HF and cardiovascular disease [7]. The main aim of the present study was to examine the relationship between resting heart rate obtained in survivors 24-36 h after admission for acute non-arrhythmic HF and in-hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

Elevated heart rate at 24–36h after admission and in-hospital mortality in acute in non-arrhythmic heart failure

Lancellotti¹,

Ancion²,

Magné³

et al. 2015

International Journal of Cardiology

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Background: Elevated resting heart rate is associated with worse outcomes in chronic heart failure (HF) but little is known about its prognostic impact in acute setting. The main aim of the present study was to examine the relationship between resting heart rate obtained 24-36 h after admission for acute non-arrhythmic HF and inhospital mortality. Methods and results:We examined the association of heart rate with in-hospital mortality in a cohort of 712 patients admitted for acute HF. None of the patients had significant arrhythmias, required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Forty patients (5.6%) died during the hospital stay. Those patients were significantly older (78 ± 9 vs. 72 ± 12 years; p = 0.0021), had higher heart rate (92 ± 22 vs. 78 ± 18 bpm; p b 0.0001), NT pro-BNP (p = 0.0005), creatinine (p = 0.023), were often diabetics (p = 0.026) and had lower systolic and diastolic blood pressures (p b 0.05). There was a significant graded relationship between the increase in mortality rate and tertile of heart rate (p b 0.01). With multivariable analysis, age (p = 0.037), heart rate (p b 0.0001), diastolic blood pressure (p b 0.001), prior ischemic heart disease (p = 0.02) and creatinine (p = 0.019) emerged as independent predictors of in-hospital mortality. After adjusting for predictors of poor prognosis, patients in the highest heart rate tertile had worst outcomes when compared with those in the lowest heart rate group (p = 0.007). Conclusions: Higher heart rate 24-36 h after admission for acute non-arrhythmic HF is associated with increased risk of in-hospital mortality. Early targeting of elevated heart rate might represent a complementary therapeutic challenge.

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“…This is also a limitation in the present study given that SBP and heart rate at discharge have also been shown to be associated with long-term prognosis. 47, 48 …”

Section: Study Limitationsmentioning

confidence: 99%

Effect of Obesity on the Prognostic Impact of Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction

Yagawa

Nagatomo

Izumi

et al. 2017

Circ J

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Background: Although obesity is associated with left ventricular hypertrophy, diastolic dysfunction, and occurrence of atrial fibrillation (AF), obese heart failure (HF) patients have a more favorable clinical outcome (obesity paradox). The clinical impact of AF on obese or lean HF patients has not been fully elucidated. Methods and Results:We analyzed 1,681 patients who were enrolled in the West Tokyo Heart Failure Registry (WET-HF Registry), a multicenter, prospective cohort registry from 2005 through 2014. We assigned them to 3 categories based on body mass index (BMI): low, BMI <18.5; medium, BMI ≥18.5 and <25; and high, BMI ≥25 (n=182/915/400). The clinical endpoint was all-cause death or readmission for acute decompensated HF. During 406 days of follow-up (IQR, 116-739 days), AF was associated with a higher risk of the endpoint in the HF with preserved ejection fraction (HFpEF) group (P<0.001, log-rank test), but not in the HF with reduced EF (HFrEF) group. AF was associated with a higher risk of the endpoint in low and medium BMI patients with HFpEF (P=0.016 and 0.009, respectively). On Multivariate Cox proportional hazards analysis, AF was an independent predictor of the endpoint in patients with BMI <25 from the HFpEF group (hazard ratio, 1.74; 95% CI: 1.21-2.54, P=0.003), but not in the other subgroups.Conclusions: AF had a negative impact on clinical outcome in non-obese patients with HFpEF.

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Association of Heart Rate at Hospital Discharge With Mortality and Hospitalizations in Patients With Heart Failure

Abstract: Higher discharge heart rates were associated with greater risk of all-cause and cardiovascular mortality≤1-year follow-up and an elevated risk of 30-day readmission for HF and cardiovascular disease.

Cited by 44 publications

References 27 publications

Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction

Soluble ST2 protein and hospitalizations due to worsening chronic heart failure during a one-year follow-up in a population with reduced ejection fraction

Elevated heart rate at 24–36h after admission and in-hospital mortality in acute in non-arrhythmic heart failure

Effect of Obesity on the Prognostic Impact of Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction

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