Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - Results from the BASKET PROVE trial

Magnus Thorsten Jensen, Christoph Kaiser, Karl Erik Sandsten, Hannes Alber, Maria Wanitschek, Allan Iversen, Jan Skov Jensen, Sune Pedersen, Rikke Soerensen, Hans Rickli, Marzena Zurek, Gregor Fahrni, Osmund Bertel, Stefano De Servi, Paul Erne, Matthias Pfisterer, Søren Galatius

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Methods Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. Results A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p = 0.006) for 60-69 bpm, 3.8 (1.2-11.9, p = 0.022) for 70-79 bpm, 4.3 (1.2-15.6, p = 0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p <0.001) for > 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR > 90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p <0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. Conclusion In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.

Original languageEnglish
Pages (from-to)3802-3806
Number of pages5
JournalInternational Journal of Cardiology
Volume168
Issue number4
DOIs
Publication statusPublished - Oct 9 2013

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Percutaneous Coronary Intervention
Acute Coronary Syndrome
Heart Rate
Stable Angina
Myocardial Infarction
Mortality
Heart Diseases
Coronary Vessels
Electrocardiography
Metals
Pharmaceutical Preparations
Population

Keywords

  • Acute coronary syndromes
  • Heart rate
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - Results from the BASKET PROVE trial. / Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren.

In: International Journal of Cardiology, Vol. 168, No. 4, 09.10.2013, p. 3802-3806.

Research output: Contribution to journalArticle

Jensen, MT, Kaiser, C, Sandsten, KE, Alber, H, Wanitschek, M, Iversen, A, Jensen, JS, Pedersen, S, Soerensen, R, Rickli, H, Zurek, M, Fahrni, G, Bertel, O, De Servi, S, Erne, P, Pfisterer, M & Galatius, S 2013, 'Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - Results from the BASKET PROVE trial', International Journal of Cardiology, vol. 168, no. 4, pp. 3802-3806. https://doi.org/10.1016/j.ijcard.2013.06.034
Jensen, Magnus Thorsten ; Kaiser, Christoph ; Sandsten, Karl Erik ; Alber, Hannes ; Wanitschek, Maria ; Iversen, Allan ; Jensen, Jan Skov ; Pedersen, Sune ; Soerensen, Rikke ; Rickli, Hans ; Zurek, Marzena ; Fahrni, Gregor ; Bertel, Osmund ; De Servi, Stefano ; Erne, Paul ; Pfisterer, Matthias ; Galatius, Søren. / Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - Results from the BASKET PROVE trial. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 4. pp. 3802-3806.
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abstract = "Background Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Methods Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. Results A total of 2029 patients with sinus rhythm were included, 722 (35.6{\%}) SAP, 647 (31.9{\%}) NSTE-ACS, and 660 (32.5{\%}) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95{\%} CI) 4.5 (1.5-13.5, p = 0.006) for 60-69 bpm, 3.8 (1.2-11.9, p = 0.022) for 70-79 bpm, 4.3 (1.2-15.6, p = 0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p <0.001) for > 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR > 90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p <0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. Conclusion In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.",
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T1 - Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes - Results from the BASKET PROVE trial

AU - Jensen, Magnus Thorsten

AU - Kaiser, Christoph

AU - Sandsten, Karl Erik

AU - Alber, Hannes

AU - Wanitschek, Maria

AU - Iversen, Allan

AU - Jensen, Jan Skov

AU - Pedersen, Sune

AU - Soerensen, Rikke

AU - Rickli, Hans

AU - Zurek, Marzena

AU - Fahrni, Gregor

AU - Bertel, Osmund

AU - De Servi, Stefano

AU - Erne, Paul

AU - Pfisterer, Matthias

AU - Galatius, Søren

PY - 2013/10/9

Y1 - 2013/10/9

N2 - Background Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Methods Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. Results A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p = 0.006) for 60-69 bpm, 3.8 (1.2-11.9, p = 0.022) for 70-79 bpm, 4.3 (1.2-15.6, p = 0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p <0.001) for > 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR > 90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p <0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. Conclusion In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.

AB - Background Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Methods Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. Results A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p = 0.006) for 60-69 bpm, 3.8 (1.2-11.9, p = 0.022) for 70-79 bpm, 4.3 (1.2-15.6, p = 0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p <0.001) for > 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR > 90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p <0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. Conclusion In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.

KW - Acute coronary syndromes

KW - Heart rate

KW - Percutaneous coronary intervention

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