Heart rate and adverse outcomes in patients with prevalent atrial fibrillation
(2021) In Open Heart 8(1).- Abstract
OBJECTIVE: The optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.
METHODS: From two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.
RESULTS: The study population consisted of 1679 patients who had prevalent AF at baseline. Mean... (More)
OBJECTIVE: The optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.
METHODS: From two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.
RESULTS: The study population consisted of 1679 patients who had prevalent AF at baseline. Mean age was 74 years, and 24.6% were women. The mean heart rate on the baseline ECG was 78 (±19) beats per minute (bpm). The median follow-up was 3.9 years (IQR 2.2-5.0). Heart rate was not significantly associated with heart failure hospitalisation (adjusted HR (aHR) per 10 bpm increase, 1.00, 95% CI 0.94 to 1.07, p=0.95), stroke or systemic embolism (aHR 0.95, 95% CI 0.84 to 1.07, p=0.38) or death (aHR 1.02, 95% CI 0.95 to 1.09, p=0.66). There was no evidence of a threshold effect for heart rates <60 bpm or >100 bpm.
CONCLUSIONS: In this large contemporary cohort of outpatients with prevalent AF, we found no association between heart rate and adverse outcome events. These data are in line with recommendations that strict heart rate control is not needed in otherwise stable outpatients with AF.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Open Heart
- volume
- 8
- issue
- 1
- article number
- e001606
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:33883229
- scopus:85104687068
- ISSN
- 2053-3624
- DOI
- 10.1136/openhrt-2021-001606
- language
- English
- LU publication?
- yes
- id
- d3f37e55-9c2d-4787-8fea-6b102e066e6f
- date added to LUP
- 2021-05-03 13:01:29
- date last changed
- 2024-06-15 10:45:53
@article{d3f37e55-9c2d-4787-8fea-6b102e066e6f,
abstract = {{<p>OBJECTIVE: The optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.</p><p>METHODS: From two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.</p><p>RESULTS: The study population consisted of 1679 patients who had prevalent AF at baseline. Mean age was 74 years, and 24.6% were women. The mean heart rate on the baseline ECG was 78 (±19) beats per minute (bpm). The median follow-up was 3.9 years (IQR 2.2-5.0). Heart rate was not significantly associated with heart failure hospitalisation (adjusted HR (aHR) per 10 bpm increase, 1.00, 95% CI 0.94 to 1.07, p=0.95), stroke or systemic embolism (aHR 0.95, 95% CI 0.84 to 1.07, p=0.38) or death (aHR 1.02, 95% CI 0.95 to 1.09, p=0.66). There was no evidence of a threshold effect for heart rates <60 bpm or >100 bpm.</p><p>CONCLUSIONS: In this large contemporary cohort of outpatients with prevalent AF, we found no association between heart rate and adverse outcome events. These data are in line with recommendations that strict heart rate control is not needed in otherwise stable outpatients with AF.</p>}},
author = {{Moschovitis, Giorgio and Johnson, Linda S B and Blum, Steffen and Aeschbacher, Stefanie and De Perna, Maria Luisa and Pagnamenta, Alberto and Mayer Melchiorre, Patrizia Assunta and Benz, Alexander P and Kobza, Richard and Di Valentino, Marcello and Zuern, Christine S and Auricchio, Angelo and Conte, Giulio and Rodondi, Nicolas and Blum, Manuel R and Beer, Juerg H and Kühne, Michael and Osswald, Stefan and Conen, David}},
issn = {{2053-3624}},
language = {{eng}},
number = {{1}},
publisher = {{BMJ Publishing Group}},
series = {{Open Heart}},
title = {{Heart rate and adverse outcomes in patients with prevalent atrial fibrillation}},
url = {{http://dx.doi.org/10.1136/openhrt-2021-001606}},
doi = {{10.1136/openhrt-2021-001606}},
volume = {{8}},
year = {{2021}},
}