初始住院心率与急性缺血性脑卒中患者的长期生存相关。
Initial in-hospital heart rate is associated with long-term survival in patients with acute ischemic stroke.
机构信息
Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.
出版信息
Clin Res Cardiol. 2022 Jun;111(6):651-662. doi: 10.1007/s00392-021-01953-5. Epub 2021 Oct 23.
AIMS
Increased heart rate has been associated with stroke risk and outcomes. The purpose of this study was to explore the long-term prognostic value of initial in-hospital heart rate in patients with acute ischemic stroke (AIS).
METHODS
We analyzed data from 21,655 patients with AIS enrolled (January 2010-September 2018) in the Chang Gung Research Database. Mean initial in-hospital heart rates were averaged and categorized into 10-beat-per-minute (bpm) increments. The primary and secondary outcomes were all-cause mortality and cardiovascular death. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable adjusted Cox proportional hazard models, using the heart rate < 60 bpm subgroup as the reference.
RESULTS
The adjusted HRs for all-cause mortality were 1.23 (95% CI 1.08-1.41) for heart rate 60-69 bpm, 1.74 (95% CI 1.53-1.97) for heart rate 70-79 bpm, 2.16 (95% CI 1.89-2.46) for heart rate 80-89 bpm, and 2.83 (95% CI 2.46-3.25) for heart rate ≥ 90 bpm compared with the reference group. Likewise, heart rate ≥ 60 bpm was also associated with an increased risk of cardiovascular death (adjusted HR 1.18 [95% CI 0.95-1.46] for heart rate 60-69 bpm, 1.57 [95% CI 1.28-1.93] for heart rate 70-79 bpm, 1.98 [95% CI 1.60-2.45] for heart rate 80-89 bpm, and 2.36 [95% CI 1.89-2.95] for heart rate ≥ 90 bpm).
CONCLUSIONS
High initial in-hospital heart rate is an independent predictor of all-cause mortality and cardiovascular death in patients with AIS.
目的
心率升高与卒中风险和结局相关。本研究旨在探讨急性缺血性卒中（AIS）患者住院初始心率与长期预后的关系。
方法
我们分析了 2010 年 1 月至 2018 年 9 月期间纳入长庚研究数据库的 21655 例 AIS 患者的数据。平均初始住院心率，以 10 次/分（bpm）递增进行分类。主要和次要结局为全因死亡率和心血管死亡。使用多变量调整的 Cox 比例风险模型估计危险比（HR）和 95%置信区间（CI），以心率＜60bpm 亚组作为参考。
结果
心率为 60-69bpm、70-79bpm、80-89bpm 和≥90bpm 时，全因死亡率的调整 HR 分别为 1.23（95%CI 1.08-1.41）、1.74（95%CI 1.53-1.97）、2.16（95%CI 1.89-2.46）和 2.83（95%CI 2.46-3.25），与参考组相比。同样，心率≥60bpm 也与心血管死亡风险增加相关（心率为 60-69bpm 时，调整 HR 为 1.18[95%CI 0.95-1.46]，心率为 70-79bpm 时，调整 HR 为 1.57[95%CI 1.28-1.93]，心率为 80-89bpm 时，调整 HR 为 1.98[95%CI 1.60-2.45]，心率≥90bpm 时，调整 HR 为 2.36[95%CI 1.89-2.95]）。
结论
住院初始心率较高是 AIS 患者全因死亡率和心血管死亡的独立预测因素。
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