Admission heart rate as a predictor of mortality in patients with acute coronary syndromes.

Introduction: Heart rate (HR) is a prognostic factor in stable angina. However, in the context of acute coronary syndromes (ACS), it is less studied.

Aims: To evaluate the influence of admission HR as a prognostic factor in patients with ACS.

Methods: We evaluated in-hospital, 30-day and one-year mortality in patients with ACS, according to admission HR.

Results: We analysed 1126 patients, 69% males, mean age 64 years, 59% with ST-segment elevation acute myocardial infarction and 15% on medication with a beta-blocker. On admission, 14% presented signs of heart failure. In 10%, left ventricular ejection fraction was < 35%. In-hospital mortality was 7.1%, 30-day mortality 9.1% and one-year mortality 10.7%. The best cut-off of HR to predict mortality was 80 bpm (sensitivity 64-66% and specificity 54-55%). By multivariate analysis, a heart rate ≥ 80 bpm was an independent predictor of all-cause mortality (HR 1.50, 95% CI: 1.01-2.23, P = 0.047).

Conclusions: In a population with ACS, a higher admission HR is an independent predictor of short- and medium-term prognosis, which is also independent of left ventricular function.