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.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_4441EE68ACE0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
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.
Journal
Atherosclerosis
Author(s)
Wang R., Takahashi K., Chichareon P., Gao C., Kogame N., Modolo R., Tomaniak M., Kawashima H., Ono M., Hara H., Schächinger V., Tonev G., Ungi I., Botelho R., Eeckhout E., Hamm C., Jüni P., Vranckx P., Windecker S., Garg S., Van Geuns R.J., Onuma Y., Serruys P.W.
ISSN
1879-1484 (Electronic)
ISSN-L
0021-9150
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
303
Pages
1-7
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
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.
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.
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.
Keywords
Follow-Up Studies, Heart Rate, Hemorrhage, Humans, Mortality, Myocardial Infarction, Percutaneous Coronary Intervention, Treatment Outcome, Coronary artery disease, Percutaneous coronary intervention, Pre-procedure heart rate, Predictor
Pubmed
Web of science
Open Access
Yes
Create date
29/06/2021 12:16
Last modification date
05/12/2023 7:10
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