title: Admission heart rate as a predictor of mortality in patients with acute coronary syndromes.
abstract: BACKGROUND
  Heart rate (HR) is a prognostic factor in stable angina. However, in the context of acute coronary syndromes (ACS), it is less studied.
  
  
  OBJECTIVE
  To evaluate the influence of admission HR as a prognostic factor in patients with ACS.
  
  
  METHODS
  We evaluated in-hospital, 30-day and one-year mortality in patients with ACS, according to admission HR.
  
  
  RESULTS
  We analysed 1126 patients, 69% males, mean age 64 years, 59% with ST-segment elevation acute myocardial infarction and 15% on medication with a beta-blocker. On admission, 14% presented signs of heart failure. In 10%, left ventricular ejection fraction was < 35%. In-hospital mortality was 7.1%, 30-day mortality 9.1% and one-year mortality 10.7%. The best cut-off of HR to predict mortality was 80 bpm (sensitivity 64-66% and specificity 54-55%). By multivariate analysis, a heart rate ≥ 80 bpm was an independent predictor of all-cause mortality (HR 1.50, 95% CI: 1.01-2.23, P = 0.047).
  
  
  CONCLUSIONS
  In a population with ACS, a higher admission HR is an independent predictor of short- and medium-term prognosis, which is also independent of left ventricular function.
authors.affiliation: Cardiology Department, Santa Marta Hospital, Centro Hospitalar de Lisboa Central, EPE Lisbon, Portugal. ana_timoteo@yahoo.com
authors.forename: Ana Teresa
authors.initials: AT
authors.lastname: Timóteo
authors.forename: Alexandra
authors.initials: A
authors.lastname: Toste
authors.forename: Ruben
authors.initials: R
authors.lastname: Ramos
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Oliveira
authors.forename: Maria Lurdes
authors.initials: ML
authors.lastname: Ferreira
authors.forename: Rui Cruz
authors.initials: RC
authors.lastname: Ferreira
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D000368:Aged; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014218:Triage