Servicio de Cardiología, Hospital Reina Sofía, Córdoba, España.
Rev Esp Cardiol. 2010 Nov;63(11):1270-80. doi: 10.1016/s1885-5857(10)70252-8.
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).
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.
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).
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.
我们的目的是研究静息心率（RHR）在广泛的稳定性冠状动脉疾病（sCAD）患者中的预后价值。
在 2000 年 2 月 1 日至 2004 年 1 月 31 日期间，招募了 1264 名患有 sCAD 的门诊患者参加前瞻性研究。患者接受了主要事件（即死亡、急性冠状动脉综合征、冠状动脉血运重建、卒中和心力衰竭住院）的随访。评估这些事件与 RHR（即≥70 次/分钟[bpm]与<70bpm）之间的关系。
患者的中位年龄为 68 岁（四分位间距[IQR]60-74 岁），926 名（73%）为男性。645 名患者（51%）的 RHR≥70bpm，619 名（49%）的 RHR<70bpm。中位随访时间为 25 个月（IQR 12-39 个月），仅有 7 名患者失访，RHR≥70bpm 的患者事件概率为 17.48%，RHR<70bpm 的患者为 17.67%（P=0.32），总死亡率分别为 2.32%和 2.5%（P=0.56）。调整年龄、性别、心血管危险因素、血压、基线心律、射血分数和首次就诊时的治疗后，RHR 与主要事件（危险比[HR]=1.04；95%置信区间[CI]，0.76-1.43；P=0.79）或死亡率（HR=1.24；95%CI，0.55-2.81；P=0.61）之间无显著相关性。
在这组未选择的 sCAD 患者中，RHR 不是不良预后因素。在该人群中，RHR 的预后价值可能较低。
