Increased discharge heart rate might be associated with increased short-term mortality after acute coronary syndrome. 2023

Umit Yuksek, and Levent Cerit, and Belma Yaman, and Hatice Kemal, and İlker Etikan, and Onur Akpınar, and Hamza Duygu
Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Turkish Republic of Northern Cyprus.

In acute coronary syndrome (ACS) patients there are mostly studies evaluating prognostic value of admission heart rate. We tried to understand the prognostic value of discharge heart rate in a spectrum of ACS patients. A total of 473 consecutive ACS patients were included in the study. Forty-three (9.1%) of them were unstable angina pectoris, 268 (56.7%) were non-ST elevation myocardial infarction and 162 (34.2%) of them were ST elevation myocardial infarction patients. Discharge heart rates of the patients were recorded and the patients were followed-up for 1 year. The primary end-point was all-cause mortality. The mean age of the patients was 64 ± 12. The patients were divided into three subgroups according to discharge heart rates (<78, 78-89, ≥90 beats per minute). Patients with a higher discharge heart rate had higher serum troponin, glucose levels and higher admission heart rates, had lower ejection fraction values and had acute heart failure complication more frequently than the patients with a lower discharge heart rate. A total of 72(16%) patients died during 1 year follow-up. In multivariate logistic regression analysis, an increased discharge heart rate was independently associated with 1-month mortality after ACS, but it was not independently associated with 6-month or 1-year mortality after ACS. Every 1 bpm increase in discharge heart rate resulted in a significant increased risk of 8.2% in 1-month all-cause mortality. Increased heart rate at discharge is an independent predictor of 1-month mortality in ACS patients. This relationship disappears after 1-month through 1-year follow-up.

UI MeSH Term Description Entries
D010351 Patient Discharge The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities. Discharge Planning,Discharge Plannings,Discharge, Patient,Discharges, Patient,Patient Discharges,Planning, Discharge,Plannings, Discharge
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072658 Non-ST Elevated Myocardial Infarction A myocardial infarction that does not produce elevations in the ST segments of the ELECTROCARDIOGRAM. ST segment elevation of the ECG is often used in determining the treatment protocol (see also ST Elevation Myocardial Infarction). NSTEMI,Non-ST-Elevation Myocardial Infarction,Infarction, Non-ST-Elevation Myocardial,Infarctions, Non-ST-Elevation Myocardial,Myocardial Infarction, Non-ST-Elevation,Myocardial Infarctions, Non-ST-Elevation,Non ST Elevated Myocardial Infarction,Non ST Elevation Myocardial Infarction,Non-ST-Elevation Myocardial Infarctions
D013610 Tachycardia Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia. Tachyarrhythmia,Tachyarrhythmias,Tachycardias
D054058 Acute Coronary Syndrome An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION. Acute Coronary Syndromes,Coronary Syndrome, Acute,Coronary Syndromes, Acute,Syndrome, Acute Coronary,Syndromes, Acute Coronary

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