NYMC Faculty Publications
Heart Rate and Outcomes in Hospitalized Patients with Heart Failure with Preserved Ejection Fraction
DOI
10.1016/j.jacc.2017.08.022
Journal Title
Journal of the American College of Cardiology
First Page
1861
Last Page
1871
Document Type
Article
Publication Date
October 2017
Department
Medicine
Abstract
BACKGROUND: A lower heart rate is associated with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). Less is known about this association in patients with HF with preserved ejection fraction (HFpEF). OBJECTIVES: The aims of this study were to examine associations of discharge heart rate with outcomes in hospitalized patients with HFpEF. METHODS: Of the 8,873 hospitalized patients with HFpEF (EF >/=50%) in the Medicare-linked OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) registry, 6,286 had a stable heart rate, defined as /=70 beats/min, balanced on 58 baseline characteristics. RESULTS: The 4,062 matched patients had a mean age of 79 +/- 10 years, 66% were women, and 10% were African American. During 6 years (median 2.8 years) of follow-up, all-cause mortality was 65% versus 70% for matched patients with a discharge heart rate /=70 beats/min, respectively (hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.80 to 0.93; p<0.001). A heart rate <70 beats/min was also associated with a lower risk for the combined endpoint of HF readmission or all-cause mortality (HR: 0.90; 95% CI: 0.84 to 0.96; p = 0.002), but not with HF readmission (HR: 0.93; 95% CI: 0.85 to 1.01) or all-cause readmission (HR: 1.01; 95% CI: 0.95 to 1.08). Similar associations were observed regardless of heart rhythm or receipt of beta-blockers. CONCLUSIONS: Among hospitalized patients with HFpEF, a lower discharge heart rate was independently associated with a lower risk of all-cause mortality, but not readmission.
Recommended Citation
Lam, P., Dooley, D., Deedwania, P., Singh, S., Bhatt, D., Aronow, W. S., Ahmed, A., Aronow, W., Anker, S., Fonarow, G., & Ahmed, A. (2017). Heart Rate and Outcomes in Hospitalized Patients with Heart Failure with Preserved Ejection Fraction. Journal of the American College of Cardiology, 70 (15), 1861-1871. https://doi.org/10.1016/j.jacc.2017.08.022
Comments
Please see the work itself for the complete list of authors.