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Prognostic Significance of Resting Heart Rate and Use of beta-Blockers in Atrial Fibrillation and Sinus Rhythm in Patients With Heart Failure and Reduced Ejection Fraction Findings From the Swedish Heart Failure Registry
Ostra Hospital, Sweden; Chinese Peoples Liberat Army Gen Hospital, Peoples R China.
Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.ORCID-id: 0000-0001-6353-8041
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2015 (engelsk)Inngår i: Circulation Heart Failure, ISSN 1941-3289, E-ISSN 1941-3297, Vol. 8, nr 5, s. 871-879Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background In heart failure and reduced ejection fraction, the prognostic role of heart rate (HR) in atrial fibrillation (AF) is unknown and the effectiveness of -blockers has recently been questioned in AF. Methods and Results A total of 18 858 patients with heart failure and reduced ejection fraction registered with Swedish Heart Failure Registry were included in this study: patients with sinus rhythm (SR; n=11 466) and patients with AF (n=7392). The outcome measure was all-cause mortality. Compared with HR 60 beats per minute, the adjusted hazard ratios for mortality in SR were 1.26 for HR=61 to 70 beats per minute, 1.37 for HR=71 to 80 beats per minute, 1.52 for HR=81 to 90 beats per minute, 1.63 for HR=91 to 100 beats per minute, and 2.69 for HR greater than100 beats per minute. However, in AF, the hazard ratio increased only for HR greater than100 beats per minute (1.30; P=0.001). -blocker use was associated with reduced mortality in SR (hazard ratio, 0.77; P=0.011) and in AF (hazard ratio, 071; Pless than0.001). For -blocker use in SR, the hazard ratio gradually increased with HR increment, whereas in AF, the hazard ratio significantly increased only for HR greater than100 beats per minute (1.29; P=0.003) compared with HR 60 beats per minute. Conclusions In patients with heart failure and reduced ejection fraction, a higher HR was associated with increased mortality in SR, but in AF, this is true only for HR greater than100 beats per minute. -blocker use was associated with reduced mortality both in SR and in AF.

sted, utgiver, år, opplag, sider
LIPPINCOTT WILLIAMS and WILKINS , 2015. Vol. 8, nr 5, s. 871-879
Emneord [en]
atrial fibrillation; heart failure; heart rate; mortality; registries
HSV kategori
Identifikatorer
URN: urn:nbn:se:liu:diva-121900DOI: 10.1161/CIRCHEARTFAILURE.115.002285ISI: 000361186000006PubMedID: 26243796OAI: oai:DiVA.org:liu-121900DiVA, id: diva2:860756
Merknad

Funding Agencies|Swedish National Board of Health and Welfare; Swedish Association of Local Authorities and Regions; Swedish Society of Cardiology; Swedish Heart-Lung Foundation

Tilgjengelig fra: 2015-10-13 Laget: 2015-10-12 Sist oppdatert: 2017-12-01

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