title: Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial.
abstract: BACKGROUND
  Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI).
  
  
  METHODS
  Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction.
  
  
  RESULTS
  A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p=0.006) for 60-69 bpm, 3.8 (1.2-11.9, p=0.022) for 70-79 bpm, 4.3 (1.2-15.6, p=0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p<0.001) for >90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p<0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use.
  
  
  CONCLUSIONS
  In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.
authors.affiliation: Copenhagen University Hospital Gentofte, Copenhagen, Denmark. Electronic address: magnustjensen@gmail.com.
authors.forename: Magnus Thorsten
authors.initials: MT
authors.lastname: Jensen
authors.forename: Christoph
authors.initials: C
authors.lastname: Kaiser
authors.forename: Karl Erik
authors.initials: KE
authors.lastname: Sandsten
authors.forename: Hannes
authors.initials: H
authors.lastname: Alber
authors.forename: Maria
authors.initials: M
authors.lastname: Wanitschek
authors.forename: Allan
authors.initials: A
authors.lastname: Iversen
authors.forename: Jan Skov
authors.initials: JS
authors.lastname: Jensen
authors.forename: Sune
authors.initials: S
authors.lastname: Pedersen
authors.forename: Rikke
authors.initials: R
authors.lastname: Soerensen
authors.forename: Hans
authors.initials: H
authors.lastname: Rickli
authors.forename: Marzena
authors.initials: M
authors.lastname: Zurek
authors.forename: Gregor
authors.initials: G
authors.lastname: Fahrni
authors.forename: Osmund
authors.initials: O
authors.lastname: Bertel
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
authors.forename: Matthias
authors.initials: M
authors.lastname: Pfisterer
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends*; D062645:Percutaneous Coronary Intervention / Q000639:trends*; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute coronary syndromes; Heart rate; Percutaneous coronary intervention