Evidence map›Paper›PMID 26411426›Full record

ArticleHerz2016

Admission heart rate in relation to presentation and prognosis in patients with acute myocardial infarction. Treatment regimens in German chest pain units.

A Perne, F P Schmidt, M Hochadel, E Giannitsis, H Darius, L S Maier, C Schmitt, G Heusch, T Voigtländer, H Mudra and 4 more

Abstract read
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In one paragraph

Article in Herz, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

A Perne2nd Department of Medicine, Johannes Gutenberg University of Mainz, Mainz, Germany.
F P Schmidt2nd Department of Medicine, Johannes Gutenberg University of Mainz, Mainz, Germany.
M HochadelInstitute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
E Giannitsis3rd Department of Medicine, University Hospital Heidelberg, Heidelberg, Germany.
H DariusDepartment of Cardiology, Angiology and Intensive Care Medicine, Vivantes-Klinikum Neukölln, Berlin, Germany.
L S Maier2nd Department of Medicine, University Hospital of Regensburg, Regensburg, Germany.
C SchmittClinic for Cardiology and Angiology, Municipal Hospital Karlsruhe, Karlsruhe, Germany.
G HeuschInstitute for Pathophysiology, West German Heart and Vascular Center University Duisburg-Essen, Essen, Germany.
T VoigtländerCCB, Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany.
H MudraDepartment of Cardiology, Pneumology and Internal Intensive Care Medicine, Klinikum Neuperlach, Städtisches Klinikum München GmbH, Munich, Germany.
T Gori2nd Department of Medicine, Johannes Gutenberg University of Mainz, Mainz, Germany.
J SengesInstitute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
T Münzel2nd Department of Medicine, Johannes Gutenberg University of Mainz, Mainz, Germany. tmuenzel@uni-mainz.de.
German Chest Pain Unit Registry
Johannes Gutenberg University Mainz · DECardiovascular Center Bethanien · DEHeidelberg University · DEUniversity Hospital Regensburg · DEStädtisches Klinikum Karlsruhe · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigher heart rates on admission have been associated with poor outcomes in patients with an acute coronary syndrome in previous cohorts. Whether such a linear relationship still exists in contemporary high-level care is unclear.

methodsProspectively collected data from patients presenting with myocardial infarction (MI) in centers participating in the Chest Pain Unit (CPU) Registry between December 2008 and July 2014 were analyzed. Patients were classified according to their initial heart rate (I: < 50; II: 50-69; III: 70-89; IV: ≥ 90 bpm). A total of 6,168 patients out of 30,339 patients presenting to 38 centers were included in the study.

resultsPatients in group IV had more comorbidities, while patients in group I more often had a history of MI. Patients in the lowest heart rate group presented significantly earlier to the hospital (4 h 31 min vs. 7 h 37 min; p < 0.05) and had the highest rate of interventions. The overall survival after 3 months was significantly worse in group IV after adjusting for baseline variables. In the subgroup analysis, heart rate was a prognostic factor in the non-ST-segment elevation MI group but not in the ST-segment elevation MI group. The correlation between heart rate and major adverse cardiac events followed a J-shaped curve with worst outcomes in the lowest and highest heart rate groups.

conclusionPatients admitted to a dedicated CPU with the diagnosis of MI and a heart rate > 90 bpm experience reduced survival at 3 months despite optimal treatment. Patients with bradycardia also seem to be at increased risk for cardiovascular events despite much earlier presentation and treatment.

Indexed as

Heart RateRegistriesAcute Coronary SyndromeAgedEmergency Medical ServicesFemaleGermanyHeart Rate DeterminationHumansMaleMiddle AgedMyocardial InfarctionPatient AdmissionPractice Patterns, Physicians'PrevalencePrognosisAcute myocardial infarctionChest Pain UnitHeart rateMortalityOutcome

Identifiers

PMID26411426
OpenAlexW2110388253

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.