Abstract 12667: Heart Rate is associated with Increased Risk of Major Cardiovascular Events, Cardiovascular and All-Cause Death in Patients with Stable Chronic Cardiovascular Disease - An Analysis of ONTARGET/ TRANSCEND
Heart rate was proposed as an emergent cardiovascular (CV) risk factor. In a post-hoc analysis of the ONTARGET/TRANSCEND trials, we evaluated associations between baseline and average heart rate (derived from repeat measurements over the duration of the trial), with CV risk in 31, 531 patients followed for a median of 5 years. The primary endpoint, major vascular events (MVE), was a composite of CV death, MI, stroke, and CHF. Pre-specified secondary endpoints included all-cause death and individual components of the primary endpoint. Associations between heart rate and outcomes were computed with heart rate as a continuous variable, baseline heart rate >70 vs ≤70 bpm, and across heart rate quintiles using Cox proportional hazards analysis, adjusting for other markers of risk, beta-blockers and non-dihydropyridine calcium channel blockers. For each 10 bpm increase in baseline and average heart rate, we observed significant increases in risk of MVE, CV death, CHF and all-cause death (Table). There was a continuous relationship between MVE and heart rate, with no observed threshold. MVE, CV death, CHF, and all-cause death increased across heart rate quintiles (Figure). Results were consistent in clinically relevant subgroups. There were modest but significant improvements in C-statistic for models that included heart rate for MVE, CV death, CHF and all-cause death. This is the largest study quantitating associations between heart rate and CV events in a contemporaneous medically optimized population with stable CV disease. Resting and average heart rate are independently associated with significant increases in CV events and all-cause death.
- Heart rate/Heart rate variability
- Coronary artery disease
- Risk factors
- Cardiovascular disease prevention
- © 2010 by American Heart Association, Inc.