Impact of admission heart rate on short-term outcome of ST-elevation myocardial infarction patients
10.3760/cma.j.issn.0253-3758.2012.01.005
- VernacularTitle:不同入院心率水平与ST段抬高型心肌梗死患者预后的关系
- Author:
Han ZHANG
1
;
Yan-Min YANG
;
Jun ZHU
;
Hui-Qiong TAN
;
Li-Sheng LIU
Author Information
1. 北京协和医学院中国医学科学院阜外心血管病医院
- Keywords:
Myocardial infarction;
Heart rate;
Outcome;
Mortality
- From:
Chinese Journal of Cardiology
2012;40(1):18-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the impact of admission heart rate(HR)on 30-day all-cause death and cardiovaseular events in Chinese patients with ST-elevation acute myocardial infarction(STEMI).Methods A total of 7485 Chinese STEMI patients from a global randomized controlled trial(CREATE)database were divided into six groups by admission HR: ＜60,60-69,70-79,80-89,90-99 and ≥ 100 bpm.The primary outcome was 30-day all-cause death; the secondary outcomes were the composite of 30-day all-cause death,reinfarction,cardiogenic shock or deadly arrhythmia.Results Admission glucose level,proportion of female gender,incidence of anterior myocardial infarction,previous diabetes mellitus,hypertension and Killip level Ⅱ-Ⅳ were significantly higher in patients with admission HR ≥ 90 bpm compared to 60-69 bpm group(P ＜ 0.05).The 30-day mortality was lowest(6.3％)in the 60-69 bpm group and was 9.6％ in HR ＜ 60 bpm group(P ＜0.05 vs.60-69 bpm group).In patients with admission HR ＞ 60 bpm,the 30-day mortality increased in proportion to higher admission HR: 8.1％ in 70-79 bpm,9.2％ in 80-89 bpm,12.6％ in 90-99 bpm and 24.6％ in ≥ 100 bpm groups(all P ＜0.05 vs.60-69bpm group).The incidence of MACE was similar as that of 30-day mortality: 27.0％ in ＜60 bpm,12.5％in 60-69 bpm,13.7％ in 70-79 bpm,14.3％ in 80-89bpm,17.5％ in90-99 bpm and 31.1％ in ≥100 bpm groups.Multivariate analysis showed that the incidence of 30-day mortality positively correlated with the admission HR(P ＜0.05)except in the patients with admission HR ＜60 bpm(OR =0.832,P =0.299),the risk of joint endpoint events was higher in the patients with HR ＜60 bpm(OR =1.532,95％CI:1.201-1.954,P＜0.05),90-99bpm(OR=1.436,95％CI:1.091-1.889,P＜0.05)or ≥100bpm(OR=1.893,95％CI:1.471-2.436,P＜0.001).Conclusion Admission HR is an independent risk factor for short-term outcome in Chinese STEMI patients.
