000			04357nam a22006497a 4500
008			171017s20172017 xxu||||| |||| 00| 0 eng d
022			_a0735-1097
040			_aOvid MEDLINE(R)
099			_a28982499
245			_aHeart Rate and Outcomes in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction.
251			_aJournal of the American College of Cardiology. 70(15):1861-1871, 2017 Oct 10
252			_aJ Am Coll Cardiol. 70(15):1861-1871, 2017 Oct 10
253			_aJournal of the American College of Cardiology
260			_c2017
260			_fFY2018
266			_d2017-10-17
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
520			_aBACKGROUND: A 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).
520			_aCONCLUSIONS: Among hospitalized patients with HFpEF, a lower discharge heart rate was independently associated with a lower risk of all-cause mortality, but not readmission. Copyright Published by Elsevier Inc.
520			_aMETHODS: Of 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.
520			_aOBJECTIVES: The aims of this study were to examine associations of discharge heart rate with outcomes in hospitalized patients with HFpEF.
520			_aRESULTS: The 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.
546			_aEnglish
650			_a*Heart Failure
650			_a*Heart Rate
650			_a*Patient Readmission/sn [Statistics & Numerical Data]
650			_a*Stroke Volume
650			_aAdrenergic beta-Antagonists/tu [Therapeutic Use]
650			_aAged
650			_aAged, 80 and over
650			_aFemale
650			_aFollow-Up Studies
650			_aHeart Failure/di [Diagnosis]
650			_aHeart Failure/mo [Mortality]
650			_aHeart Failure/pp [Physiopathology]
650			_aHeart Failure/th [Therapy]
650			_aHospitalization/sn [Statistics & Numerical Data]
650			_aHumans
650			_aMale
650			_aMedicare/sn [Statistics & Numerical Data]
650			_aMortality
650			_aOutcome and Process Assessment (Health Care)
650			_aPatient Acuity
650			_aPatient Discharge/sn [Statistics & Numerical Data]
650			_aProportional Hazards Models
650			_aRegistries
650			_aRisk Assessment
650			_aUnited States/ep [Epidemiology]
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aDooley, Daniel J
700			_aLam, Phillip H
700			_aMohammed, Selma F
790			_aAhmed A, Allman RM, Anker SD, Aronow WS, Arundel C, Bhatt DL, Blackman MR, Butler J, Deedwania P, Dooley DJ, Fonarow GC, Lam PH, Love TE, Mohammed SF, Morgan CJ, Panjrath G, Singh SN, White M, Wu WC, Zile MR
856			_uhttps://dx.doi.org/10.1016/j.jacc.2017.08.022 _zhttps://dx.doi.org/10.1016/j.jacc.2017.08.022
942			_cART _dArticle
999			_c2784 _d2784