TY - JOUR
T1 - The impact of pre-procedure heart rate on adverse clinical outcomes in patients undergoing percutaneous coronary intervention: Results from a 2-year follow-up of the GLOBAL LEADERS trial
AU - Wang, Rutao
AU - Takahashi, Kuniaki
AU - Chichareon, Ply
AU - Gao, Chao
AU - Kogame, Norihiro
AU - Modolo, Rodrigo
AU - Tomaniak, Mariusz
AU - Kawashima, Hideyuki
AU - Ono, Masafumi
AU - Hara, Hironori
AU - Schächinger, Volker
AU - Tonev, Gincho
AU - Ungi, Imre
AU - Botelho, Roberto
AU - Eeckhout, Eric
AU - Hamm, Christian
AU - Jüni, Peter
AU - Vranckx, Pascal
AU - Windecker, Stephan
AU - Garg, Scot
AU - van Geuns, Robert Jan
AU - Onuma, Yoshinobu
AU - Serruys, Patrick W.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Background and aims: The prognostic impact of pre-procedure heart rate (PHR) following percutaneous coronary intervention (PCI) has not yet been fully investigated. This post-hoc analysis sought to assess the impact of PHR on medium-term outcomes among patients having PCI, who were enrolled in the “all-comers” GLOBAL LEADERS trial. Methods and results: The primary endpoint (composite of all-cause death or new Q-wave myocardial infarction [MI]) and key secondary safety endpoint (bleeding according to Bleeding Academic Research Consortium [BARC] type 3 or 5) were assessed at 2 years. PHR was available in 15,855 patients, and when evaluated as a continuous variable (5 bpm increase) and following adjustment using multivariate Cox regression, it significantly correlated with the primary endpoint (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.03–1.09, p < 0.001). Using dichotomous cut-off criteria, a PHR>67 bpm was associated with increased all-cause mortality (HR 1.38, 95%CI 1.13–1.69, p = 0.002) and more frequent new Q-wave MI (HR 1.41, 95%CI 1.02–1.93, p = 0.037). No significant association was found between PHR and BARC 3 or 5 bleeding (HR 1.04, 95% CI 0.99–1.09, p = 0.099). There was no interaction with the primary (p-inter = 0.236) or secondary endpoint (p-inter = 0.154) when high and low PHR was analyzed according to different antiplatelet strategies. Conclusions: Elevated PHR was an independent predictor of all-cause mortality at 2 years following PCI in the “all-comer” GLOBAL LEADERS trial. The prognostic value of increased PHR on outcomes was not affected by the different antiplatelet strategies in this trial.
AB - Background and aims: The prognostic impact of pre-procedure heart rate (PHR) following percutaneous coronary intervention (PCI) has not yet been fully investigated. This post-hoc analysis sought to assess the impact of PHR on medium-term outcomes among patients having PCI, who were enrolled in the “all-comers” GLOBAL LEADERS trial. Methods and results: The primary endpoint (composite of all-cause death or new Q-wave myocardial infarction [MI]) and key secondary safety endpoint (bleeding according to Bleeding Academic Research Consortium [BARC] type 3 or 5) were assessed at 2 years. PHR was available in 15,855 patients, and when evaluated as a continuous variable (5 bpm increase) and following adjustment using multivariate Cox regression, it significantly correlated with the primary endpoint (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.03–1.09, p < 0.001). Using dichotomous cut-off criteria, a PHR>67 bpm was associated with increased all-cause mortality (HR 1.38, 95%CI 1.13–1.69, p = 0.002) and more frequent new Q-wave MI (HR 1.41, 95%CI 1.02–1.93, p = 0.037). No significant association was found between PHR and BARC 3 or 5 bleeding (HR 1.04, 95% CI 0.99–1.09, p = 0.099). There was no interaction with the primary (p-inter = 0.236) or secondary endpoint (p-inter = 0.154) when high and low PHR was analyzed according to different antiplatelet strategies. Conclusions: Elevated PHR was an independent predictor of all-cause mortality at 2 years following PCI in the “all-comer” GLOBAL LEADERS trial. The prognostic value of increased PHR on outcomes was not affected by the different antiplatelet strategies in this trial.
KW - Coronary artery disease
KW - Mortality
KW - Percutaneous coronary intervention
KW - Pre-procedure heart rate
KW - Predictor
UR - http://www.scopus.com/inward/record.url?scp=85085049908&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.atherosclerosis.2020.04.010
DO - https://doi.org/10.1016/j.atherosclerosis.2020.04.010
M3 - Article
C2 - 32450456
SN - 0021-9150
VL - 303
SP - 1
EP - 7
JO - Atherosclerosis
JF - Atherosclerosis
ER -