Heart rate at admission is a predictor of in-hospital mortality in patients with acute coronary syndromes: Results from 58 European hospitals: The European Hospital Benchmarking by Outcomes in acute coronary syndrome Processes study

Abstract

Heart rate at admission is significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS. ACS patients with admission heart rate above 80 bpm are at highest risk of in-hospital mortality.

Admission Heart Rate Is Associated With Coronary Artery Disease Severity and Complexity in Patients With Acute Coronary Syndrome

“…2 Recently, Jensen et al demonstrated that admission HR was significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS and that patients with ACS with admission HR above 80 bpm were at the highest risk of in-hospital mortality. 26 Recent evidence suggests an important role of HR in the pathophysiology of atherosclerosis. In experimental and clinical studies, elevated HR has been shown to be associated with oxidative stress, systemic inflammation, and resultant endothelial dysfunction, which facilitate the formation of atherosclerosis.…”

General glycosylated hemoglobin goals potentially increase myocardial infarction severity in diabetes patients with comorbidities: Insights from a nationwide multicenter study

“…Using HbA1c for the diagnosis of diabetes mellitus has several strengths, it measures the average plasma glucose level over 2-3 months, is largely unaffected by acute illness and could be used to guide management 24 . Simultaneously, clinical features selected in the present study not only represent the cardiac 2,3,25 . Whereas MVD has been proved to be a strong risk factor for recurrent cardiovascular events in a long-term nationwide study 26 .…”

“…Simultaneously, clinical features selected in the present study not only represent the cardiac damage and systemic change in STEMI, but also have considerable prognostic value. AHR and Killip classification are both univariate and multivariate predictors of poor prognosis after MI 2,3,25 . Whereas MVD has been proved to be a strong risk factor for recurrent cardiovascular events in a long‐term nationwide study 26 .…”

“…Admission heart rate (AHR) and Killip classification are fundamental indexes reflecting cardiac function and general condition. Both of them are important predictors of mortality in STEMI 2,3 . Coronary angiogram has long been the gold standard for evaluation of CAD, while the number of stenosed vessels based on angiographic evaluation is an early indicator to estimate the progression of CAD 4,5 .…”

Improving outcomes of acute coronary syndromes through better risk stratification, earlier and more accurate diagnosis of acute myocardial infarction and assessment of frailty

“…Analysis of a large contemporary dataset of ACS patients admitted to 58 hospitals from 6 participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) collaboration showed a U-shaped relationship between admission heart rate and in-hospital mortality both in STEMI and NSTEACS patients. 9 Both a high (>80 bpm) as a well a low heart rate (<50 to 60 bpm) was associated with an increased mortality. Patients with a marked bradycardia on admission (<40 bpm) had the highest risk and may represent a ' pre-cardiogenic shock' subgroup that presented with lower blood pressure, haemoglobin and worse kidney function at admission.…”