Byeon Jaeho, Choo Eun Ho, Choi Ik Jun, Lee Kwan Yong, Hwang Byung-Hee, Kim Chan Joon, Jeon Doo Soo, Ahn Youngkeun, Jeong Myung Ho, Chang Kiyuk
Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2023 May 29;12(11):3734. doi: 10.3390/jcm12113734.
An elevated heart rate at admission or discharge is known to be associated with poor cardiovascular outcomes in patients with acute myocardial infarction (AMI). The association between post-discharge average office-visit heart rate and cardiovascular outcomes in patients with AMI has rarely been studied. We analyzed data for 7840 patients from the COREA-AMI registry who had their heart rates measured at least three times after hospital discharge. The office-visit heart rates were averaged and categorized into four groups by quartiles (<68, 68-74, 74-80, and >80 beats per minute). The primary end point was a composite of cardiovascular death, myocardial infarction, and ischemic stroke. During a median of 5.7 years of follow-up, major adverse cardiovascular events (MACE) affected 1357 (17.3%) patients. An average heart rate higher than 80 bpm was associated with an increased incidence of MACE compared to the reference average heart rate of 68-74 bpm. When dichotomized into <74 or ≥74 bpm, a lower average heart rate was not associated with MACE in patients with LV systolic dysfunction, in contrast to those without LV systolic dysfunction. An elevated average heart rate at office visits after AMI was associated with an increased risk of cardiovascular outcomes. Heart rate monitoring at office visits after discharge provides an important predictor related to cardiovascular events.
入院时或出院时心率升高已知与急性心肌梗死（AMI）患者不良心血管结局相关。AMI患者出院后门诊平均心率与心血管结局之间的关联鲜有研究。我们分析了COREA-AMI注册研究中7840例患者的数据，这些患者在出院后至少测量了三次心率。计算门诊心率的平均值，并按四分位数分为四组（<68、68-74、74-80和>80次/分钟）。主要终点是心血管死亡、心肌梗死和缺血性卒中的复合终点。在中位5.7年的随访期间，1357例（17.3%）患者发生了主要不良心血管事件（MACE）。与平均心率68-74次/分钟的参考值相比，平均心率高于80次/分钟与MACE发生率增加相关。当分为<74或≥74次/分钟时，与无左心室收缩功能障碍的患者相比，左心室收缩功能障碍患者的较低平均心率与MACE无关。AMI后门诊平均心率升高与心血管结局风险增加相关。出院后门诊心率监测提供了一个与心血管事件相关的重要预测指标。
