Nidal Asaad, Ayman El-Menyar, Khalid F AlHabib, Adel Shabana, Alawi A Alsheikh-Ali, Wael Almahmeed, Hussam Al Faleh, Ahmad Hersi, Shukri Al Saif, Ahmed Al-Motarreb, Kadhim Sulaiman, Khalid Al Nemer, Haitham Amin, Jassim Al Suwaidi
{"title":"Initial heart rate and cardiovascular outcomes in patients presenting with acute coronary syndrome.","authors":"Nidal Asaad, Ayman El-Menyar, Khalid F AlHabib, Adel Shabana, Alawi A Alsheikh-Ali, Wael Almahmeed, Hussam Al Faleh, Ahmad Hersi, Shukri Al Saif, Ahmed Al-Motarreb, Kadhim Sulaiman, Khalid Al Nemer, Haitham Amin, Jassim Al Suwaidi","doi":"10.3109/17482941.2014.889312","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60-69, III: 70-79, IV: 80-89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared.</p><p><strong>Results: </strong>Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39-3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04-3.85) CONCLUSION: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"16 2","pages":"49-56"},"PeriodicalIF":0.0000,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2014.889312","citationCount":"9","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute cardiac care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3109/17482941.2014.889312","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/4/4 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 9
Abstract
Objectives: To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS).
Methods: Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60-69, III: 70-79, IV: 80-89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared.
Results: Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39-3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04-3.85) CONCLUSION: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.