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Resting heart rate and cardiovascular outcomes in patients with atrial fibrillation: CODE-AF registry

Title: Resting heart rate and cardiovascular outcomes in patients with atrial fibrillation: CODE-AF registry
Authors: Park, H; Yu, HT; Kim, TH; Park, J; Park, JK; Kang, KW; Shim, J; Kim, JB; Kim, J; Choi, EK; Park, HW; Lee, YS; Joung, B
Source: EP Europace ; volume 24, issue Supplement_1 ; ISSN 1099-5129 1532-2092
Publisher Information: Oxford University Press (OUP)
Publication Year: 2022
Description: Funding Acknowledgements Type of funding sources: None. Background The prognostic significance of resting heart rate and its therapeutic target in atrial fibrillation (AF) is uncertain. Purpose The aim of this study was to investigate the relationships between resting heart rate and cardiovascular outcomes in patients with AF. Methods A total of 8,886 patients with AF was included from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry. Patients were categorized according to baseline heart rate, and cardiovascular outcomes were accessed during a median follow-up of 30 months. The primary outcome was a composite of cardiovascular death, hospitalization due to heart failure, and myocardial infarction/critical limb ischemia. Results Compared to heart rate ≥100 beats per minute (bpm), heart rate 80-99 bpm was associated with the lowest risk of primary outcome (adjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.40-0.79, p=0.001). In subgroup of patients with heart failure with preserved ejection fraction (HFpEF), heart rate between 80-99 bpm was associated with reduced risk of primary outcome compared to heart rate ≥100 bpm (HR 0.40, 95% CI 0.16-0.98, p=0.045). However, in patients with heart failure with reduced ejection fraction (HFrEF), there was no association between resting heart rate and cardiovascular outcomes (P for interaction 0.001). Conclusion Resting heart rate was associated with cardiovascular outcomes in patients with AF, and those with a resting heart rate between 80-99 bpm had the lowest risk of adverse events. The impact of resting heart rate on adverse events persisted in patients with concomitant HFpEF but was not apparent in those with concomitant HFrEF.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/europace/euac053.182
Availability: https://doi.org/10.1093/europace/euac053.182; https://academic.oup.com/europace/article-pdf/24/Supplement_1/euac053.182/43769895/euac053.182.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
Accession Number: edsbas.2EC48AB1
Database: BASE