The relationship between heart rate and mortality of patients with acute coronary syndromes in the coronary intervention era: Meta-analysis

BACKGROUND: Most of acute coronary syndromes (ACS) were receiving intervention treatment a high overall rate of coronary angiography in the modern medical practice. Consequently, we conduct a review to determine the heart rate (HR) on the prognosis of ACS in the coronary intervention era. METHODS: PubMed, EMBASE, MEDLINE, and the Cochrane Library was systematically searched up to May 2016 using the search terms “heart rate,” “acute coronary syndrome,” “acute myocardial infarction,” “ST elevation myocardial infarction,” “non-ST-segment elevation.” The outcome of interest was all-cause mortality. All analyses were performed using Review Manager. RESULTS: Database searches retrieved 2324 citations. Eleven studies enrolling 156,374 patients were included. In-hospital mortality was significantly higher in the elevated HR group compared to the lower HR group (pooled RR 2.04, 95%CI 1.80–2.30, P < 0.0001). Individuals with elevated admission HR had increased risk of long-term mortality (Pooled RR = 1.63, 95%CI 1.27–2.10, P = 0.008) compared to lower admission HR. The pooled results showed elevated discharge and resting HR were related to increased mortality of patients with ACS (pooled RR 1.88, 95% CI 1.02–3.47, P = 0.04; pooled RR 2.14, 95%CI 1.37–3.33, P < 0.0001, respectively). CONCLUSION: Elevated HR may increase the mortality of ACS patients in the percutaneous coronary intervention era.