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European Heart Journal Advance Access first published online on March 17, 2005
This version published online on March 21, 2005

European Heart Journal, doi:10.1093/eurheartj/ehi190
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received October 22, 2004
Revised February 1, 2005
Accepted February 3, 2005

Clinical research

Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease

Ariel Diaz 1, Martial G. Bourassa 1, Marie-Claude Guertin 2, and Jean-Claude Tardif 1*

1 Department of Medicine, Research Center, Montreal Heart Institute, 5000 Belanger Street E,H1T 1C8 Montreal, Canada
2 Montreal Heart Institute Coordinating Center (MHICC), Montreal, Quebec, Canada

* To whom correspondence should be addressed.
Jean-Claude Tardif, E-mail: jean-claude.tardif{at}icm-mhi.org


   Abstract

Aims Heart rate reduction is the cornerstone of the treatment of angina. The purpose of this study was to explore the prognostic value of heart rate in patients with stable coronary artery disease (CAD).

Methods and results We assessed the relationship between resting heart rate at baseline and cardiovascular mortality/morbidity, while adjusting for risk factors. A total of 24 913 patients with suspected or proven CAD from the Coronary Artery Surgery Study registry were studied for a median follow-up of 14.7 years. All-cause and cardiovascular mortality and cardiovascular rehospitalizations were increased with increasing heart rate (P<0.0001). Patients with resting heart rate ≥83 bpm at baseline had a significantly higher risk for total mortality [hazard ratio (HR)=1.32, CI 1.19-1.47, P<0.0001] and cardiovascular mortality (HR=1.31, CI 1.15-1.48, P<0.0001) after adjustment for multiple clinical variables when compared with the reference group. When comparing patients with heart rates between 77-82 and ≥83 bpm with patients with a heart rate ≤62 bpm, the HR values for time to first cardiovascular rehospitalization were 1.11 and 1.14, respectively (P<0.001 for both).

Conclusion Resting heart rate is a simple measurement with prognostic implications. High resting heart rate is a predictor for total and cardiovascular mortality independent of other risk factors in patients with CAD.

Keywords: High resting heart rate; Prognosis; Coronary heart disease; Mortality; Cardiovascular mortality; Rehospitalizations.
The originally published version of this paper was incorrect. The first author's name was incorrectly spelt and should have appeared as 'Ariel Diaz'. The author apologizes that this error was not identified earlier.
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