Document Detail

Respiratory rate predicts outcome after acute myocardial infarction: a prospective cohort study.
MedLine Citation:
PMID:  23242188     Owner:  NLM     Status:  MEDLINE    
AIMS: Risk stratification after acute myocardial infarction (MI) remains imperfect and new indices are sought that might improve the post-MI risk assessment. In a contemporarily-treated cohort of acute MI patients, we tested whether the respiratory rate provides prognostic information and how this information compares to that of established risk assessment.
METHODS AND RESULTS: A total of 941 consecutive patients (mean age 61 years, 19% female) presenting with acute MI were enrolled between May 2000 and March 2005. The last follow-up was performed May 2010. Main outcome measure was total mortality during a follow-up period of 5 years. Patients underwent 10-min resting recordings of the respiratory rate within 2 weeks after MI in addition to the measurement of the left ventricular ejection fraction (LVEF) and standard clinical assessment including the GRACE score. During the follow-up, 72 patients died. The respiratory rate was a significant predictor of death in univariable analysis (hazard ratio 1.19 per 1/min, 95% confidence interval: 1.12-1.27) as was the GRACE score [1.04 (1.03-1.05) per point], LVEF [0.96 (0.94-0.97) per 1%], and the diagnosis of diabetes mellitus [2.78 (1.73-4.47)], all P < 0.0001. On multivariate analysis, the GRACE score (P < 0.0001), respiratory rate (P < 0.0001), LVEF (P = 0.013), and diabetes (P = 0.016) were independent prognostic markers.
CONCLUSION: The respiratory rate provides powerful prognostic information which is independent and complementary to that of existing risk assessment. Simple and inexpensive assessment of the respiratory rate should be considered a complementary variable for the assessment of risk after acute MI.
Petra Barthel; Roland Wensel; Axel Bauer; Alexander Müller; Petra Wolf; Kurt Ulm; Katharina M Huster; Darrel P Francis; Marek Malik; Georg Schmidt
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't     Date:  2012-12-14
Journal Detail:
Title:  European heart journal     Volume:  34     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-10     Completed Date:  2014-01-15     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1644-50     Citation Subset:  IM    
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MeSH Terms
Area Under Curve
Middle Aged
Myocardial Infarction / mortality,  physiopathology*
Prospective Studies
Pulmonary Disease, Chronic Obstructive / mortality,  physiopathology
Respiratory Rate / physiology*
Risk Assessment
Stroke Volume / physiology
Grant Support
FS/10/038//British Heart Foundation; FS/10/38/28268//British Heart Foundation

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

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