title: Prognostic role of heart rate in patients referred for coronary angiography: age and sex differences.
abstract: OBJECTIVE To evaluate the predictive value of resting heart rate (RHR) for cardiac and total mortality in a large population of patients referred for coronary angiography with an extended follow-up, stratified in four subpopulations according to gender and age (50th percentile corresponding to 67 years).
  
  
  METHODS
  We studied 3559 subjects (2603 males, age: 66 ± 11 years, mean ± SD), obtaining patient data from the Institute electronic databank which saves demographic, clinical, instrumental and follow-up data of patients admitted to our department.
  
  
  RESULTS
  During a mean follow-up period of 35 ± 25 months, 296 (8%) patients died; there were 173 (5%) cardiac deaths. In female patients irrespective of age, RHR (≥ 76 bpm, 75th percentile) did not appear predictive for cardiac death. In females, RHR was predictive for overall mortality after multivariate adjustment only in those aged ≥ 67 years (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1-2.8, p ≤ 0.05). In male patients aged < 67 years, RHR remained as an independent predictive factor for overall mortality at the multivariate analysis (HR 2.5, 95% CI 1.5-4.2, p < 0.001), and as an independent predictor for both cardiac mortality (HR 1.8, 95% CI 1.2-2.7, p < 0.01) and total mortality (HR 1.6, 95% CI 1.2-2.3, p < 0.01) in male patients over 67 years.
  
  
  CONCLUSIONS
  The current study suggests that the prognostic importance of RHR may differ according to the patient's gender and age, suggesting significant differences in cardiovascular physiopathology between female and male patients.
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology-CNR , Pisa , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Vassalle
authors.forename: S
authors.initials: S
authors.lastname: Maffei
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: P
authors.initials: P
authors.lastname: Landi
authors.forename: C
authors.initials: C
authors.lastname: Carpeggiani
mesh_terms: D000367:Age Factors; D000368:Aged; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000401:mortality*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012146:Rest / Q000502:physiology; D012737:Sex Factors
keywords: CARDIAC MORTALITY; CARDIOVASCULAR DISEASE; GENDER; OVERALL MORTALITY; PROGNOSIS; RESTING HEART RATE