Heart rate and use of β-blockers in Mexican stable outpatients with coronary artery disease.
OBJECTIVE
To evaluate the use of β-blockers and to monitor heart rate in Mexican patients with coronary artery disease.


METHODS
CLARIFY is an outpatients registry with stable CAD. A total of 33,283 patients from 45 countries were enrolled between November 2009 and July 2010 from which 1342 were Mexican patients.


RESULTS
The mean HR pulse was 70 bpm (beats per minute). Patients in Mexico were compared with the remaining global CLARIFY population. Patients in Mexico had a higher incidence of acute myocardial infarction and percutaneous coronary intervention, and lower incidence of revascularization surgery compared with the remaining CLARIFY population. More often, Mexican patients presented with diabetes, but less often hypertension and stroke. These patients were split into three mutually exclusive groups of HR ≤ 60 (N=263), HR 61-69 (N=356) and HR ≥ 70 (N=722). Patients with elevated HR had a higher incidence of diabetes and higher diastolic blood pressure on average than those with controlled HR. Regarding the use of β-blockers, they were used in 63.3% of patients, 2.7% showed intolerance or contraindication to treatment to monitor heart rate, and ivabradine was used in 2.3%. Out of approximately 849 patients receiving treatment of β-blockers, 52.1% had ≥ 70 bpm HR.


CONCLUSIONS
In a large proportion of Mexican patients with stable coronary disease the HR remain elevated, > 70 bpm, even with the use of β-blockers; this requires further attention.
Instituto de Corazón de Querétaro, Querétaro, Mexico; Coordinador Nacional CLARIFY, Mexico; Sociedad Mexicana de Cardiología. Electronic address: Marco.alcocerg@gmail.com.
Marco Antonio
MA
Alcocer-Gamba
Sociedad Mexicana de Cardiología; Instituto Nacional de Cardiología "Ignacio Chávez", Cd México, Mexico.
Carlos
C
Martínez-Sánchez
Sociedad Mexicana de Cardiología; Instituto Nacional de Cardiología "Ignacio Chávez", Cd México, Mexico.
Juan
J
Verdejo-Paris
Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, Italy.
Roberto
R
Ferrari
NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom.
Kim
K
Fox
University of Glasgow, Glasgow, United Kingdom.
Nicola
N
Greenlaw
NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom; INSERM, U698, Paris, France; Université Paris Diderot, Paris, France; AP-HP, Hôpital Bichat, Paris, France.
Gabriel
G
Steg Philippe
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000553:Ambulatory Care; D003324:Coronary Artery Disease / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies
D000319:Adrenergic beta-Antagonists
Beta bloqueadores; Enfermedad coronaria estable; Frecuencia cardiaca; Heart rate; Mexico; México; Stable coronary artery disease; β-Blockers