Long-term prognostic importance of resting heart rate in patients with left ventricular dysfunction in connection with either heart failure or myocardial infarction: the DIAMOND study
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Long-term prognostic importance of resting heart rate in patients with left ventricular dysfunction in connection with either heart failure or myocardial infarction: the DIAMOND study. / Fosbøl, Emil Loldrup; Seibaek, Marie; Brendorp, Bente; Moller, Daniel Vega; Thune, Jens Jakob; Gislason, Gunnar H; Torp-Pedersen, Christian; Køber, Lars; Danish Investigations and Arrhythmia ON Dofetilide Study Group; Fosbøl, Emil Loldrup; Seibaek, Marie; Brendorp, Bente; Møller, Daniel Vega; Thune, Jens Jakob; Gislason, Gunnar H; Torp-Pedersen, Christian; Køber, Lars; Danish Investigations and Arrhythmia ON Dofetilide Study Group.
I: International Journal of Cardiology, Bind 140, Nr. 3, 30.04.2010, s. 279-86.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Long-term prognostic importance of resting heart rate in patients with left ventricular dysfunction in connection with either heart failure or myocardial infarction: the DIAMOND study
AU - Fosbøl, Emil Loldrup
AU - Seibaek, Marie
AU - Brendorp, Bente
AU - Moller, Daniel Vega
AU - Thune, Jens Jakob
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
AU - Køber, Lars
AU - Danish Investigations and Arrhythmia ON Dofetilide Study Group
AU - Fosbøl, Emil Loldrup
AU - Seibaek, Marie
AU - Brendorp, Bente
AU - Møller, Daniel Vega
AU - Thune, Jens Jakob
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
AU - Køber, Lars
AU - Danish Investigations and Arrhythmia ON Dofetilide Study Group
N1 - Keywords: Aged; Aged, 80 and over; Denmark; Female; Follow-Up Studies; Heart Failure; Heart Rate; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Prognosis; Proportional Hazards Models; Survival Rate; Ventricular Dysfunction, Left
PY - 2010/4/30
Y1 - 2010/4/30
N2 - BACKGROUND: Elevated resting heart rate is associated with increased mortality in a variety of cardiac diseases, but comparisons between different clinical settings are lacking. We investigated the long-term prognostic importance of resting heart rate in patients hospitalized with left ventricular dysfunction in connection with either heart failure (HF) or myocardial infarction (MI). METHODS: In the Danish Investigations and Arrhythmia ON Dofetilide (DIAMOND) study; patients with left ventricular dysfunction were randomized to Dofetilide (class III antiarrhythmic drug) or placebo. One part of the study enrolled 1518 patients with HF and another 1510 patients with MI. Mortality analyses were performed using multivariable adjusted Cox proportional hazard models. RESULTS: During 10 years of follow-up, 1076 (72%) patients with MI and 1336 (89%) patients with HF died. In multivariable adjusted models, every increment in baseline heart rate of 10 bpm was associated with an increase in mortality in both MI-patients (hazard ratio, 1.14; 95%-confidence interval (CI): 1.09-1.19; P<.0001) and HF-patients (hazard ratio, 1.10; CI: 1.06-1.15; P<.0001). The importance of resting heart rate on short-term prognosis was stronger in the MI patients compared to the HF patients (P<.0001 for interaction). There was no interaction between heart rate and beta-blockade, and inclusion of beta-blockade in the model did not change the results. CONCLUSIONS: Resting heart rate was independently associated with increased risk of overall mortality. The prognostic importance of resting heart rate is stronger in patients with MI compared to patients with HF, especially in the short term.
AB - BACKGROUND: Elevated resting heart rate is associated with increased mortality in a variety of cardiac diseases, but comparisons between different clinical settings are lacking. We investigated the long-term prognostic importance of resting heart rate in patients hospitalized with left ventricular dysfunction in connection with either heart failure (HF) or myocardial infarction (MI). METHODS: In the Danish Investigations and Arrhythmia ON Dofetilide (DIAMOND) study; patients with left ventricular dysfunction were randomized to Dofetilide (class III antiarrhythmic drug) or placebo. One part of the study enrolled 1518 patients with HF and another 1510 patients with MI. Mortality analyses were performed using multivariable adjusted Cox proportional hazard models. RESULTS: During 10 years of follow-up, 1076 (72%) patients with MI and 1336 (89%) patients with HF died. In multivariable adjusted models, every increment in baseline heart rate of 10 bpm was associated with an increase in mortality in both MI-patients (hazard ratio, 1.14; 95%-confidence interval (CI): 1.09-1.19; P<.0001) and HF-patients (hazard ratio, 1.10; CI: 1.06-1.15; P<.0001). The importance of resting heart rate on short-term prognosis was stronger in the MI patients compared to the HF patients (P<.0001 for interaction). There was no interaction between heart rate and beta-blockade, and inclusion of beta-blockade in the model did not change the results. CONCLUSIONS: Resting heart rate was independently associated with increased risk of overall mortality. The prognostic importance of resting heart rate is stronger in patients with MI compared to patients with HF, especially in the short term.
U2 - 10.1016/j.ijcard.2008.11.084
DO - 10.1016/j.ijcard.2008.11.084
M3 - Journal article
C2 - 19095316
VL - 140
SP - 279
EP - 286
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -
ID: 22127333