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Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry

BACKGROUND: Although heart rate (HR) is reportedly associated with major cardiovascular outcomes in the general population, its impact on adverse events in patients with non-valvular atrial fibrillation (NVAF) remains controversial. Thus, we performed post hoc analyses of data from the J-RHYTHM Regi...

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Autores principales: Kodani, Eitaro, Inoue, Hiroshi, Atarashi, Hirotsugu, Okumura, Ken, Yamashita, Takeshi, Origasa, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678716/
https://www.ncbi.nlm.nih.gov/pubmed/36425566
http://dx.doi.org/10.1016/j.ijcha.2022.101148
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author Kodani, Eitaro
Inoue, Hiroshi
Atarashi, Hirotsugu
Okumura, Ken
Yamashita, Takeshi
Origasa, Hideki
author_facet Kodani, Eitaro
Inoue, Hiroshi
Atarashi, Hirotsugu
Okumura, Ken
Yamashita, Takeshi
Origasa, Hideki
author_sort Kodani, Eitaro
collection PubMed
description BACKGROUND: Although heart rate (HR) is reportedly associated with major cardiovascular outcomes in the general population, its impact on adverse events in patients with non-valvular atrial fibrillation (NVAF) remains controversial. Thus, we performed post hoc analyses of data from the J-RHYTHM Registry to clarify this in patients with NVAF. RESULTS: Of 7406 outpatients with NVAF from 158 institutions, 6886 (age, 69.8 ± 9.9 years; men, 70.8%), in whom both baseline HR and HR-end (at the time closest to an event or at the last visit of follow-up) were measured during the two-year follow-up period or until the occurrence of an event, constituted the study group. The baseline HR and HR-end values were 72.5 ± 13.3 bpm and 73.3 ± 13.3 bpm, respectively. Thromboembolism, major hemorrhage, all-cause death, and cardiovascular death occurred in 117 (1.7%), 130 (1.9%), 157 (2.3%), and 58 (0.8%) patients, respectively. Baseline HR was not associated with any adverse event, whereas HR-end (per 1-bpm increase) was significantly associated with an increased incidence of all adverse events. Furthermore, the highest quartile of HR-end (≥80 bpm) was independently associated with the incidence of major hemorrhage (adjusted odds ratio [OR], 2.90; 95% confidence interval [CI], 1.69–4.96; P < 0.001), all-cause death (OR, 3.42; 95% CI, 1.99–5.88; P < 0.001), and cardiovascular death (OR, 5.07; 95% CI, 1.49–17.22; P = 0.009) compared with the second quartile (64–71 bpm), even after adjusting for known confounding factors, HR-controlling drug use, and systolic blood pressure-end. CONCLUSIONS: In patients with NVAF, HR-end was significantly associated with adverse events independent of systolic blood pressure-end, whereas baseline HR was not.
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spelling pubmed-96787162022-11-23 Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry Kodani, Eitaro Inoue, Hiroshi Atarashi, Hirotsugu Okumura, Ken Yamashita, Takeshi Origasa, Hideki Int J Cardiol Heart Vasc Original Paper BACKGROUND: Although heart rate (HR) is reportedly associated with major cardiovascular outcomes in the general population, its impact on adverse events in patients with non-valvular atrial fibrillation (NVAF) remains controversial. Thus, we performed post hoc analyses of data from the J-RHYTHM Registry to clarify this in patients with NVAF. RESULTS: Of 7406 outpatients with NVAF from 158 institutions, 6886 (age, 69.8 ± 9.9 years; men, 70.8%), in whom both baseline HR and HR-end (at the time closest to an event or at the last visit of follow-up) were measured during the two-year follow-up period or until the occurrence of an event, constituted the study group. The baseline HR and HR-end values were 72.5 ± 13.3 bpm and 73.3 ± 13.3 bpm, respectively. Thromboembolism, major hemorrhage, all-cause death, and cardiovascular death occurred in 117 (1.7%), 130 (1.9%), 157 (2.3%), and 58 (0.8%) patients, respectively. Baseline HR was not associated with any adverse event, whereas HR-end (per 1-bpm increase) was significantly associated with an increased incidence of all adverse events. Furthermore, the highest quartile of HR-end (≥80 bpm) was independently associated with the incidence of major hemorrhage (adjusted odds ratio [OR], 2.90; 95% confidence interval [CI], 1.69–4.96; P < 0.001), all-cause death (OR, 3.42; 95% CI, 1.99–5.88; P < 0.001), and cardiovascular death (OR, 5.07; 95% CI, 1.49–17.22; P = 0.009) compared with the second quartile (64–71 bpm), even after adjusting for known confounding factors, HR-controlling drug use, and systolic blood pressure-end. CONCLUSIONS: In patients with NVAF, HR-end was significantly associated with adverse events independent of systolic blood pressure-end, whereas baseline HR was not. Elsevier 2022-11-17 /pmc/articles/PMC9678716/ /pubmed/36425566 http://dx.doi.org/10.1016/j.ijcha.2022.101148 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Paper
Kodani, Eitaro
Inoue, Hiroshi
Atarashi, Hirotsugu
Okumura, Ken
Yamashita, Takeshi
Origasa, Hideki
Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title_full Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title_fullStr Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title_full_unstemmed Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title_short Impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: Subanalysis of the J-RHYTHM Registry
title_sort impact of heart rate on adverse events in patients with non-valvular atrial fibrillation: subanalysis of the j-rhythm registry
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678716/
https://www.ncbi.nlm.nih.gov/pubmed/36425566
http://dx.doi.org/10.1016/j.ijcha.2022.101148
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