title: Prognostic value of resting heart rate on cardiovascular and renal outcomes in type 2 diabetic patients: a competing risk analysis in a prospective cohort.
abstract: OBJECTIVE
  Epidemiological studies and randomized clinical trials have demonstrated in various populations that resting heart rate (RHR) was an independent predictor of cardiovascular (CV) risk and all-cause mortality. However, few data specifically evaluated the relationship between RHR and long-term CV and renal complications in a large population of type 2 diabetic (T2D) patients.
  
  
  METHODS
  We performed a single-center, prospective analysis in 1,088 T2D patients. RHR was determined at baseline by electrocardiogram. The primary outcome was a composite criterion of CV and renal morbi-mortality (CV death, nonfatal myocardial infarction and/or stroke, hospitalization for heart failure, renal replacement therapy), which was adjusted for death from non-CV cause as a competing event. The secondary outcome was a renal composite criterion (renal replacement therapy or doubling of baseline serum creatinine) adjusted for all-cause death as a competing event.
  
  
  RESULTS
  During median follow-up of 4.2 years, 253 patients (23%) and 62 patients (6%) experienced the primary and secondary outcomes, respectively. In the subgroup of patients with CV disease history at baseline (n = 336), RHR was found to be associated with the incidence of primary outcome (P = 0.0002) but also with renal risk alone, adjusted for all-cause death as a competing event (secondary outcome; P < 0.0001). In patients without history of CV disease, no relation was found between RHR and the incidence of CV and/or renal events.
  
  
  CONCLUSIONS
  In the real-life setting, RHR constitutes an easy and less time-consuming factor that would permit identification of CV disease diabetic patients with an increased risk for long-term CV and renal complications.
authors: CHU de Poitiers, Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Poitiers, France.
authors: Aurelie
authors: A
authors: Miot
authors: Stéphanie
authors: S
authors: Ragot
authors: Wala
authors: W
authors: Hammi
authors: Pierre-Jean
authors: PJ
authors: Saulnier
authors: Philippe
authors: P
authors: Sosner
authors: Xavier
authors: X
authors: Piguel
authors: Florence
authors: F
authors: Torremocha
authors: Richard
authors: R
authors: Marechaud
authors: Samy
authors: S
authors: Hadjadj
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality*; D003928:Diabetic Nephropathies / Q000401:mortality*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors