Heart rate is a prognostic risk factor for myocardial infarction: a post hoc analysis in the PERFORM (Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack) study population
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Authors
Fox, KimBousser, Marie-Germaine
Amarenco, Pierre
Chamorro, Angel
Fisher, Marc
Ford, Ian
Hennerici, Michael G.
Mattle, Heinrich P.
Rothwell, Peter M.
UMass Chan Affiliations
Department of NeurologyDocument Type
Journal ArticlePublication Date
2013-10-09Keywords
AgedFemale
Heart Rate
Humans
Ischemic Attack, Transient
Male
Middle Aged
Myocardial Infarction
Myocardial Ischemia
Naphthalenes
Prognosis
Propionates
Risk Factors
Stroke
Cardiology
Cardiovascular Diseases
Neurology
Metadata
Show full item recordAbstract
BACKGROUND: Elevated resting heart rate is known to be detrimental to morbidity and mortality in cardiovascular disease, though its effect in patients with ischemic stroke is unclear. We analyzed the effect of baseline resting heart rate on myocardial infarction (MI) in patients with a recent noncardioembolic cerebral ischemic event participating in PERFORM. METHODS: We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate < 70 bpm (n=8178) or > /=70 bpm (n=10,802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored. RESULTS: Heart rate > /=70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95% CI 1.03-1.69, P=0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3%, P=0.0002). Heart rate > /=70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P < 0001); vascular death (P < 0001); all-cause mortality (P < 0001); and fatal or nonfatal stroke (P=0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7%, P < 0.0001), vascular death (11.0%, P < 0.0001), all-cause mortality (8.0%, P < 0.0001), and fatal and nonfatal stroke (2.4%, P=0.057). CONCLUSION: Elevated heart rate > /=70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI.Source
Int J Cardiol. 2013 Oct 9;168(4):3500-5. doi: 10.1016/j.ijcard.2013.04.206. Epub 2013 May 22.Link to article on publisher's siteDOI
10.1016/j.ijcard.2013.04.206Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30479PubMed ID
23706327Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.ijcard.2013.04.206