Kangning Han MD , Xia Li PhD , Biao Fu MD , Mengmeng Li MD , Tong Liu MD , Chenxi Jiang MD , Ribo Tang MD , Jianzeng Dong MD , Deyong Long MD , Changsheng Ma MD
{"title":"心房颤动患者静息心率与死亡率之间的纵向关系","authors":"Kangning Han MD , Xia Li PhD , Biao Fu MD , Mengmeng Li MD , Tong Liu MD , Chenxi Jiang MD , Ribo Tang MD , Jianzeng Dong MD , Deyong Long MD , Changsheng Ma MD","doi":"10.1016/j.amjcard.2024.10.012","DOIUrl":null,"url":null,"abstract":"<div><div>Rate control plays a fundamental role in the management of atrial fibrillation (AF), but the optimal target of resting heart rate (RHR) for reducing mortality remains uncertain. This study used longitudinal follow-up RHR data to evaluate the relation between RHR and all-cause mortality. Data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study were retrospectively analyzed. The association between RHR and mortality was longitudinally analyzed using mean RHR (mRHR) and trajectory patterns, where the Cox proportional hazards model and group-based trajectory model were used. A total of 3,921 patients (mean age, 69.47 ± 8.09 years) with AF were included in our study. A total of 578 deaths were recorded during a median follow-up of 3.4 years. Cox regression analyses showed an mRHR ≥80 bpm was associated with an increased risk of mortality (adjusted hazard ratio: 2.01, 95% confidence interval 1.59 to 2.55). Consistent association was found in the subgroup analyses. The Kaplan-Meier analysis showed notably reduced survival probabilities for patients with mRHR ≥80 bpm. Patients were classified into 4 stable trajectories based on RHR during follow-up, with the classes >70 bpm associated with an elevated risk of mortality. In conclusion, longitudinally measured RHR ≥80 bpm was associated with an increased risk of mortality in patients with AF.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"234 ","pages":"Pages 38-46"},"PeriodicalIF":2.3000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longitudinal Association Between Resting Heart Rate and Mortality in Atrial Fibrillation\",\"authors\":\"Kangning Han MD , Xia Li PhD , Biao Fu MD , Mengmeng Li MD , Tong Liu MD , Chenxi Jiang MD , Ribo Tang MD , Jianzeng Dong MD , Deyong Long MD , Changsheng Ma MD\",\"doi\":\"10.1016/j.amjcard.2024.10.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Rate control plays a fundamental role in the management of atrial fibrillation (AF), but the optimal target of resting heart rate (RHR) for reducing mortality remains uncertain. This study used longitudinal follow-up RHR data to evaluate the relation between RHR and all-cause mortality. Data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study were retrospectively analyzed. The association between RHR and mortality was longitudinally analyzed using mean RHR (mRHR) and trajectory patterns, where the Cox proportional hazards model and group-based trajectory model were used. A total of 3,921 patients (mean age, 69.47 ± 8.09 years) with AF were included in our study. A total of 578 deaths were recorded during a median follow-up of 3.4 years. Cox regression analyses showed an mRHR ≥80 bpm was associated with an increased risk of mortality (adjusted hazard ratio: 2.01, 95% confidence interval 1.59 to 2.55). Consistent association was found in the subgroup analyses. The Kaplan-Meier analysis showed notably reduced survival probabilities for patients with mRHR ≥80 bpm. Patients were classified into 4 stable trajectories based on RHR during follow-up, with the classes >70 bpm associated with an elevated risk of mortality. In conclusion, longitudinally measured RHR ≥80 bpm was associated with an increased risk of mortality in patients with AF.</div></div>\",\"PeriodicalId\":7705,\"journal\":{\"name\":\"American Journal of Cardiology\",\"volume\":\"234 \",\"pages\":\"Pages 38-46\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002914924007434\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002914924007434","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Longitudinal Association Between Resting Heart Rate and Mortality in Atrial Fibrillation
Rate control plays a fundamental role in the management of atrial fibrillation (AF), but the optimal target of resting heart rate (RHR) for reducing mortality remains uncertain. This study used longitudinal follow-up RHR data to evaluate the relation between RHR and all-cause mortality. Data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study were retrospectively analyzed. The association between RHR and mortality was longitudinally analyzed using mean RHR (mRHR) and trajectory patterns, where the Cox proportional hazards model and group-based trajectory model were used. A total of 3,921 patients (mean age, 69.47 ± 8.09 years) with AF were included in our study. A total of 578 deaths were recorded during a median follow-up of 3.4 years. Cox regression analyses showed an mRHR ≥80 bpm was associated with an increased risk of mortality (adjusted hazard ratio: 2.01, 95% confidence interval 1.59 to 2.55). Consistent association was found in the subgroup analyses. The Kaplan-Meier analysis showed notably reduced survival probabilities for patients with mRHR ≥80 bpm. Patients were classified into 4 stable trajectories based on RHR during follow-up, with the classes >70 bpm associated with an elevated risk of mortality. In conclusion, longitudinally measured RHR ≥80 bpm was associated with an increased risk of mortality in patients with AF.
期刊介绍:
Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.