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KMID : 1011920230240010015
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International Journal of Arrhythmia
2023 Volume.24 No. 1 p.15 ~ p.15
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Resting heart rate and cardiovascular outcomes in patients with non-paroxysmal atrial fibrillation: CODE-AF registry
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Park Han-Jin
Yu Hee-Tae
Kim Tae-Hoon
Park Jun-Beom
Park Jin-Kyu
Kang Ki-Woon
Shim Jae-Min
Kim Jin-Bae
Kim Jun
Choi Eue-Keun
Park Hyung-Wook
Lee Young-Soo
Joung Bo-Young
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Abstract
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Background : The prognostic significance of resting heart rate and its therapeutic target in atrial fibrillation (AF) is uncertain. We sought to investigate the relationship between resting heart rate and cardiovascular outcomes in patients with non-paroxysmal AF (non-PAF).
Methods : In this propensity score-weighted, multi-center prospective cohort study, 3217 patients with non-PAF were analyzed. Patients were categorized according to the baseline resting heart rate and cardiovascular outcomes were accessed for a median follow-up of 30 months. The primary outcome was a composite of cardiovascular death, heart failure hospitalization, and myocardial infarction/critical limb ischemia.
Results : Freedom from primary outcome was longest among patients with resting heart rate 80?99 beats per minute (bpm) whereas shortest among those with?≤?59 bpm (weighted log rank, p?=?0.008). Compared with heart rate?≥?100 bpm, resting heart rate 80?99 and 60?79 bpm was associated with reduced risk of primary outcome (weighted hazard ratio [WHR] 0.52, 95% confidence interval [CI] 0.32?0.84, p?=?0.008 and WHR 0.58, 95% CI 0.37?0.92, p?=?0.021 for heart rate 80?99 and 60?79 bpm, respectively). Using weighted restricted cubic spline curves, there was a U-shaped association between the resting heart rate and primary outcome with reduced risk of primary outcome in heart rate range of 68?99 bpm. This association was maintained regardless of atrioventricular node (AVN) blocker use or persistent/permanent AF (p for interaction 0.767 for AVN blocker use and 0.720 for AF type).
Conclusion : Resting heart rate was associated with cardiovascular outcomes in patients with non-PAF and those with resting heart rate between 68 and 99 bpm had lower risk of adverse cardiovascular events regardless of AVN blocker use or persistent/permanent AF.
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KEYWORD
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Heart rate, Atrial fbrillation, Heart failure, Prognosis
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