Prognostic value of resting heart rate in a broad population of patients with stable coronary artery disease: prospective single-center cohort study.

INTRODUCTION AND OBJECTIVES

Our aim was to investigate the prognostic value of the resting heart rate (RHR) in a broad unselected population of patients with stable coronary artery disease (sCAD).

METHOD

Between February 1, 2000 and January 31, 2004, 1264 ambulatory patients with sCAD were recruited into the prospective study. Patients were followed up for major events (i.e. death, acute coronary syndrome, coronary revascularization, stroke, and hospitalization for heart failure). Associations between these events and the RHR (i.e. ≥ 70 beats per minute [bpm] versus < 70 bpm) were evaluated.

RESULTS

The patients' median age was 68 years (interquartile range [IQR] 60-74 years) and 926 (73%) were male. The RHR was ≥ 70 bpm in 645 patients (51%) and < 70 bpm in 619 (49%). After a median follow-up period of 25 months (IQR 12-39 months), with only seven patients lost to follow-up, the probability of an event was 17.48% in patients with an RHR ≥ 70 bpm and 17.67% in those with an RHR < 70 bpm (P =. 32) and total mortality was 2.32% and 2.5%, respectively (P = .56). After adjustment for age, sex, cardiovascular risk factors, blood pressure, baseline cardiac rhythm, ejection fraction and treatment at first visit, no significant association was found between the RHR and major events (hazard ratio [HR] = 1.04; 95% confidence interval [CI], 0.76-1.43; P = .79) or mortality (HR = 1.24; 95% CI, 0.55-2.81; P=.61).

CONCLUSIONS

The RHR was not an adverse prognostic factor in this group of unselected patients with sCAD. The prognostic value of the RHR in daily clinical practice could be low in this population.