Initial heart rate and cardiovascular outcomes in patients presenting with acute coronary syndrome.
OBJECTIVE
To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS).


METHODS
Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60-69, III: 70-79, IV: 80-89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared.


RESULTS
Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39-3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04-3.85) CONCLUSION: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.
Department of Cardiology, Heart Hospital, Hamad Medical Corporation , Qatar.
Nidal
N
Asaad
Ayman
A
El-Menyar
Khalid F
KF
AlHabib
Adel
A
Shabana
Alawi A
AA
Alsheikh-Ali
Wael
W
Almahmeed
Hussam
H
Al Faleh
Ahmad
A
Hersi
Shukri
S
Al Saif
Ahmed
A
Al-Motarreb
Kadhim
K
Sulaiman
Khalid
K
Al Nemer
Haitham
H
Amin
Jassim
J
Al Suwaidi
D054058:Acute Coronary Syndrome / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D000367:Age Factors; D000368:Aged; D001919:Bradycardia / Q000150:complications*; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013610:Tachycardia / Q000150:complications*; D016896:Treatment Outcome