TY  - BOOK
AU  - Dooley, Daniel J
AU  - Lam, Phillip H
AU  - Mohammed, Selma F
TI  - Heart Rate and Outcomes in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction
SN  - 0735-1097
PY  - 2017///
KW  - *Heart Failure
KW  - *Heart Rate
KW  - *Patient Readmission/sn [Statistics & Numerical Data]
KW  - *Stroke Volume
KW  - Adrenergic beta-Antagonists/tu [Therapeutic Use]
KW  - Aged
KW  - Aged, 80 and over
KW  - Female
KW  - Follow-Up Studies
KW  - Heart Failure/di [Diagnosis]
KW  - Heart Failure/mo [Mortality]
KW  - Heart Failure/pp [Physiopathology]
KW  - Heart Failure/th [Therapy]
KW  - Hospitalization/sn [Statistics & Numerical Data]
KW  - Humans
KW  - Male
KW  - Medicare/sn [Statistics & Numerical Data]
KW  - Mortality
KW  - Outcome and Process Assessment (Health Care)
KW  - Patient Acuity
KW  - Patient Discharge/sn [Statistics & Numerical Data]
KW  - Proportional Hazards Models
KW  - Registries
KW  - Risk Assessment
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: A lower heart rate is associated with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). Less is known about this association in patients with HF with preserved ejection fraction (HFpEF); CONCLUSIONS: Among hospitalized patients with HFpEF, a lower discharge heart rate was independently associated with a lower risk of all-cause mortality, but not readmission. Copyright Published by Elsevier Inc; METHODS: Of the 8,873 hospitalized patients with HFpEF (EF >=50%) in the Medicare-linked OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) registry, 6,286 had a stable heart rate, defined as <=20 beats/min variation between admission and discharge. Of these, 2,369 (38%) had a discharge heart rate of <70 beats/min. Propensity scores for discharge heart rate <70 beats/min, estimated for each of the 6,286 patients, were used to assemble a cohort of 2,031 pairs of patients with heart rate <70 versus >=70 beats/min, balanced on 58 baseline characteristics; OBJECTIVES: The aims of this study were to examine associations of discharge heart rate with outcomes in hospitalized patients with HFpEF; RESULTS: The 4,062 matched patients had a mean age of 79 +/- 10 years, 66% were women, and 10% were African American. During 6 years (median 2.8 years) of follow-up, all-cause mortality was 65% versus 70% for matched patients with a discharge heart rate <70 versus >=70 beats/min, respectively (hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.80 to 0.93; p < 0.001). A heart rate <70 beats/min was also associated with a lower risk for the combined endpoint of HF readmission or all-cause mortality (HR: 0.90; 95% CI: 0.84 to 0.96; p = 0.002), but not with HF readmission (HR: 0.93; 95% CI: 0.85 to 1.01) or all-cause readmission (HR: 1.01; 95% CI: 0.95 to 1.08). Similar associations were observed regardless of heart rhythm or receipt of beta-blockers
UR  - https://dx.doi.org/10.1016/j.jacc.2017.08.022
ER  -