Coronary artery diseaseUsefulness of Postoperative Heart Rate as an Independent Predictor of Mortality After Coronary Bypass Grafting
Section snippets
Methods
This observational cohort study was designed for the risk prediction of perioperative and postoperative events after CABG. Data collection and variables definition have been described in detail elsewhere.7, 8
Briefly, we included all patients referred to our department for CABG from September 1998 to August 2002 in a prospective longitudinal cohort study.
Clinical recording began approximately 1 month before surgery in case of nonurgent CABG, during the anesthetist outpatient visit, and was
Results
Among the 1,022 patients enrolled, 32 died during the first month after CABG and were thus excluded from this analysis. Thirty-five additional patients were excluded because of missing data regarding preoperative (n = 5) and postoperative (n = 30) HR. Among the remaining 955 patients, 161 underwent concomitant valvular and/or vascular surgery and were thus excluded from statistical analysis. The baseline characteristics of the remaining 794 patients are listed in Table 1. Mean preoperative and
Discussion
In this study, we found that postoperative HR at rest measured 2 months after CABG was associated with long-term cardiovascular events. Higher HR was also associated with mortality, but this association was not found independent from other covariates. The strongest independent association between cardiovascular events and HR was demonstrated for values >90 beats/min. To our knowledge, this is the first specific study addressing the predictive value of HR in the setting of patients with coronary
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Cited by (7)
Usefulness of Discharge Resting Heart Rate to Predict Adverse Cardiovascular Outcomes in Patients With Left Main Coronary Artery Disease Revascularized With Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting (from the EXCEL Trial)
2020, American Journal of CardiologyCitation Excerpt :The major findings from the present analysis from the EXCEL trial, in which the association between RHR at discharge and clinical outcomes following revascularization for LMCAD with PCI or CABG was examined, are as follows: (i) Increasing RHR at discharge was an independent predictor of a higher rate of 3-year adverse outcomes, including mortality; (ii) revascularization modality (PCI vs CABG) did not modulate the discharge RHR-related risk of adverse outcomes; and (iii) utilization of beta blockers did not affect the association between discharge RHR and adverse outcomes. Previous studies have indicated that increasing baseline or discharge RHR in patients treated with either PCI8–10,15 or CABG16–18 portends an increased risk of adverse clinical outcomes. To our knowledge, the present study is the first study to examine the clinical impact of discharge RHR following percutaneous or surgical revascularization in patients with LMCAD.
Heart Rate as a Predictor of Outcome Following Percutaneous Coronary Intervention
2018, American Journal of CardiologyCitation Excerpt :Our secondary analysis findings support those of several studies that propose a HR threshold of 70 beats/min beyond which poorer outcome can be anticipated in patients with CAD.6,7,9 This threshold was previously thought to be higher, with other reports suggesting a range from 75 to 90 beats/min.2,3,10,11 Most importantly, our findings suggest that this threshold remains present even in a cohort with lower rates of left ventricular (LV) dysfunction and heart failure.
NO ASSOCIATION OF EARLY POSTOPERATIVE HEART RATE WITH OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING
2022, American Journal of Critical CareA Comprehensive Secondary Prevention Benchmark (2PBM) Score Identifying Differences in Secondary Prevention Care in Patients After Acute Coronary Syndrome
2023, Journal of Cardiopulmonary Rehabilitation and PreventionPredictive Value of Increased Perioperative Heart Rate for All-Cause Mortality After Cardiac Surgery: A Systematic Review and Meta-Analysis
2022, Biological Research for NursingResting heart rate and outcomes in patients with cardiovascular disease: Where do we currently stand?
2013, Cardiovascular Therapeutics