Evidence map›Paper›PMID 28982499›Full record

ArticleJournal of the American College of Cardiology2017

Heart Rate and Outcomes in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction.

Phillip H Lam, Daniel J Dooley, Prakash Deedwania, Steven N Singh, Deepak L Bhatt, Charity J Morgan, Javed Butler, Selma F Mohammed, Wen-Chih Wu, Gurusher Panjrath and 10 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
3.9field-weighted citation impact, top 5% 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

20 citing papers in PubMed, 38 citations in OpenAlex.

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  20. Sex-Specific Physiology and Cardiovascular Disease.Advances in experimental medicine and biology
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 15 institutions in 3 countries.

Phillip H LamCenter for Health and Aging, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, Georgetown University, Washington, DC; Division of Cardiology, MedStar Washington Hospital Center, Washington, DC.
Daniel J DooleyCenter for Health and Aging, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, Georgetown University, Washington, DC; Division of Cardiology, MedStar Washington Hospital Center, Washington, DC.
Prakash DeedwaniaCenter for Health and Aging, Veterans Affairs Medical Center, Washington, DC; Division of Cardiology, Department of Medicine, University of California, San Francisco, Fresno, California.
Steven N SinghDepartment of Medicine, Georgetown University, Washington, DC; Section of Cardiology, Department of Medicine, Veterans Affairs Medical Center, Washington, DC.
Deepak L BhattDepartment of Medicine, Brigham and Women's Hospital Heart & Vascular Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Charity J MorganDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
Javed ButlerDivision of Cardiology, Department of Medicine, Stony Brook University, Stony Brook, New York.
Selma F MohammedDivision of Cardiology, MedStar Washington Hospital Center, Washington, DC.
Wen-Chih WuSection of Cardiology, Department of Medicine, Veterans Affairs Medical Center, Providence, Rhode Island; Division of Cardiology, Department of Medicine, Brown University, Providence, Rhode Island.
Gurusher PanjrathDepartment of Medicine, George Washington University, Washington, DC.
Michael R ZileSection of Cardiology, Department of Medicine, Ralph H. Johnson VA Medical Center, Charleston, South Carolina; Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Michel WhiteDivision of Cardiology, Montreal Heart Institute, Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Cherinne ArundelDepartment of Medicine, Georgetown University, Washington, DC; Department of Medicine, George Washington University, Washington, DC; Hospitalist Section, Medical Service Department, Veterans Affairs Medical Center, Washington, DC.
Thomas E LoveDepartment of Medicine, Department of Population and Quantitative Health Sciences, and Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, Ohio.
Marc R BlackmanCenter for Health and Aging, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, Georgetown University, Washington, DC; Department of Medicine, George Washington University, Washington, DC.
Richard M AllmanGeriatrics and Extended Care, Department of Veterans Affairs, Washington, DC.
Wilbert S AronowDivision of Cardiology, Department of Medicine, Westchester Medical Center, Valhalla, New York; Division of Cardiology, Department of Medicine, New York Medical College, Valhalla, New York.
Stefan D AnkerDivision of Cardiology and Metabolism-Heart Failure, Cachexia & Sarcopenia, Department of Cardiology (CVK), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), and Deutsches Zentrum für Herz-Kreislauf-Forschung (German Centre for Cardiovascular Research), Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Cardiology and Pneumology, University Medicine Göttingen, Göttingen, Germany.
Gregg C FonarowDivision of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California.
Ali AhmedCenter for Health and Aging, Veterans Affairs Medical Center, Washington, DC; Department of Medicine, George Washington University, Washington, DC; Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: aliahmedmdmph@gmail.com.
MedStar Washington Hospital Center · USGeorgetown University · USGeorge Washington University · USBrigham and Women's Hospital · USCase Western Reserve University · USDeutsches Herzzentrum der Charité · DEGeorge Washington University Hospital · USMedical University of South Carolina · USMontreal Heart Institute · CAProvidence College · USSan Francisco VA Medical Center · USStony Brook University · USUniversity of Alabama at Birmingham · USUniversity of California, Los Angeles · USWestchester Medical Center · US

Funding

Maternal Morbidity and Mortality: Risk Factors, Early Detection and Personalized InterventionUL1TR001409 · NCATS · GEORGETOWN UNIVERSITY · PI GONDRE-LEWIS, MARJORIE C, MELLMAN, THOMAS A · 2015 to 2024
$37.8M
Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NCATS NIH HHS UL1 TR001409NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01 HL097047
6 · The paper itself

Abstract

backgroundA lower heart rate is associated with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF). Less is known about this association in patients with HF with preserved ejection fraction (HFpEF).

objectivesThe aims of this study were to examine associations of discharge heart rate with outcomes in hospitalized patients with HFpEF.

methodsOf the 8,873 hospitalized patients with HFpEF (EF ≥50%) in the Medicare-linked OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) registry, 6,286 had a stable heart rate, defined as ≤20 beats/min variation between admission and discharge. Of these, 2,369 (38%) had a discharge heart rate of <70 beats/min. Propensity scores for discharge heart rate <70 beats/min, estimated for each of the 6,286 patients, were used to assemble a cohort of 2,031 pairs of patients with heart rate <70 versus ≥70 beats/min, balanced on 58 baseline characteristics.

resultsThe 4,062 matched patients had a mean age of 79 ± 10 years, 66% were women, and 10% were African American. During 6 years (median 2.8 years) of follow-up, all-cause mortality was 65% versus 70% for matched patients with a discharge heart rate <70 versus ≥70 beats/min, respectively (hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.80 to 0.93; p < 0.001). A heart rate <70 beats/min was also associated with a lower risk for the combined endpoint of HF readmission or all-cause mortality (HR: 0.90; 95% CI: 0.84 to 0.96; p = 0.002), but not with HF readmission (HR: 0.93; 95% CI: 0.85 to 1.01) or all-cause readmission (HR: 1.01; 95% CI: 0.95 to 1.08). Similar associations were observed regardless of heart rhythm or receipt of beta-blockers.

conclusionsAmong hospitalized patients with HFpEF, a lower discharge heart rate was independently associated with a lower risk of all-cause mortality, but not readmission.

Indexed as

Heart FailureHeart RateStroke VolumeAdrenergic beta-AntagonistsAgedAged, 80 and overFemaleFollow-Up StudiesHospitalizationHumansMaleMedicareMortalityOutcome and Process Assessment, Health CarePatient AcuityPatient DischargeAdrenergic beta-Antagonistsall-cause mortalityall-cause readmissionatrial fibrillationbeta-blockerspropensity score

Identifiers

PMID28982499
PMCPMC8801201
OpenAlexW2763578299

What OpenQuestion holds

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Registered trials

None linked

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.