Document Detail


Does initial and delayed heart rate predict mortality in patients with acute coronary syndromes?
MedLine Citation:
PMID:  14979625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lower admission heart rate (HR) is known to predict favorable outcome in ST-elevation acute myocardial infarction. However, there are limited short-term and no long-term data available regarding the prediction value of the initial HR in patients with the full spectrum of acute coronary syndromes (ACS). In addition, it is unknown whether the HR obtained later during hospitalization for ACS (i.e., Day 2 or 3) remains prognostically valuable. HYPOTHESIS: The aim of this study was to investigate the utility of the initial and delayed HR in predicting outcome in patients with ACS. METHODS: We examined mortality at 30 days and 10 months in 10,267 patients with ACS enrolled in the oral glycoprotein IIb/IIIa inhibition with Orofiban in Patients with Unstable coronary Syndromes-Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 trial. Patients were stratified by HR and day from onset of ACS into the following groups: (1) HR < 60 beats/min, (2) HR 60-80 beats/min, (3) HR 80-100 beats/min, (4) HR > 100 beats/min; and HR obtained on (1) Day 1, (2) Day 2, and (3) Day 3. RESULTS: By univariate analysis, mortality at 30 days and at 10 months increased progressively with higher HR strata (1.4 vs. 1.6 vs. 2.3 vs. 5.6%, p < 0.001, and 2.6 vs. 4.2 vs. 6.5 vs. 11.8%, p < 0.001, respectively). Elevated HR remained associated with mortality irrespective of time from onset of ACS. CONCLUSIONS: Higher initial and delayed HR is highly predictive of higher short- and long-term mortality in patients with ACS. This is a simple marker that could be easily used in risk assessment.
Authors:
David Kovar; Christopher P Cannon; Jane H Bentley; Andrew Charlesworth; William J Rogers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  27     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-24     Completed Date:  2004-07-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  80-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA. david_kovar@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Alanine / antagonists & inhibitors
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy,  mortality*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Predictive Value of Tests
Prognosis
Pyrrolidines / antagonists & inhibitors
Syndrome
Chemical
Reg. No./Substance:
0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/Pyrrolidines; 165800-05-5/orbofiban; 56-41-7/Alanine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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