PMID- 26358762 OWN - NLM STAT- MEDLINE DCOM- 20161006 LR - 20161230 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 17 IP - 11 DP - 2015 Nov TI - Is heart rate a risk marker in patients with chronic heart failure and concomitant atrial fibrillation? Results from the MAGGIC meta-analysis. PG - 1182-91 LID - 10.1002/ejhf.346 [doi] AB - AIM: To investigate the relationship between heart rate and survival in patients with heart failure (HF) and coexisting atrial fibrillation (AF). METHODS AND RESULTS: Patients with AF included in the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) meta-analysis were the main focus of this analysis (3259 patients from 17 studies). The outcome was all-cause mortality at 3 years. Heart rate was analysed as a categorical (tertiles; T1 /=98 b.p.m.) and continuous variable. Cox proportional hazard models were used to compare the risk of all-cause death between tertiles of baseline heart rate. Patients in the highest tertile were more often female, less likely to have an ischaemic aetiology or diabetes, had a lower ejection fraction but higher blood pressure and New York Heart Association (NYHA) class. Higher heart rate was associated with higher mortality in patients with sinus rhythm (SR) but not in those in AF. In patients with heart failure and reduced ejection fraction (HF-REF) and AF, death rates per 100 patient years were lowest in the highest heart rate tertile (T1 18.9 vs. T3 15.9) but this difference was not statistically significant (P = 0.10). In patients with heart failure and preserved ejection fraction (HF-PEF), death rates per 100 patient years were highest in the highest heart rate tertile (T1 14.6 vs. T3 16.0, P = 0.014). However, after adjustment for other important prognostic variables, higher heart rate was no longer associated with higher mortality in HF-PEF (or HF-REF). CONCLUSIONS: In this meta-analysis of patients with HF, heart rate does not have the same prognostic significance in patients in AF as it does in those in SR, irrespective of ejection fraction or treatment with beta-blocker. CI - (c) 2015 The Authors European Journal of Heart Failure (c) 2015 European Society of Cardiology. FAU - Simpson, Joanne AU - Simpson J AD - BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. FAU - Castagno, Davide AU - Castagno D AD - Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy. FAU - Doughty, Rob N AU - Doughty RN AD - Department of Medicine and National Institute of Health Innovation, University of Auckland, Auckland, New Zealand. FAU - Poppe, Katrina K AU - Poppe KK AD - Department of Medicine and National Institute of Health Innovation, University of Auckland, Auckland, New Zealand. FAU - Earle, Nikki AU - Earle N AD - Department of Medicine and National Institute of Health Innovation, University of Auckland, Auckland, New Zealand. FAU - Squire, Iain AU - Squire I AD - University of Leicester, Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK. FAU - Richards, Mark AU - Richards M AD - University of Otago, Christchurch, Department of Medicine, Christchurch, New Zealand. FAU - Andersson, Bert AU - Andersson B AD - Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden. FAU - Ezekowitz, Justin A AU - Ezekowitz JA AD - Division of Cardiology and Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. FAU - Komajda, Michel AU - Komajda M AD - Universite Paris 6, Pitie Salpetriere Hospital, Paris, France. FAU - Petrie, Mark C AU - Petrie MC AD - Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, UK. FAU - McAlister, Finlay A AU - McAlister FA AD - The Division of General Internal Medicine, University of Alberta, Edmonton, Canada. FAU - Gamble, Greg D AU - Gamble GD AD - Department of Medicine and National Institute of Health Innovation, University of Auckland, Auckland, New Zealand. FAU - Whalley, Gillian A AU - Whalley GA AD - Faculty of Social and Health Sciences, Unitec, Auckland, New Zealand. FAU - McMurray, John J V AU - McMurray JJ AD - BHF Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK. CN - Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't DEP - 20150911 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 0 (Adrenergic beta-Antagonists) SB - IM MH - Adrenergic beta-Antagonists/*therapeutic use MH - Aged MH - *Atrial Fibrillation/complications/diagnosis/drug therapy/physiopathology MH - Cause of Death MH - Female MH - *Heart Failure/complications/diagnosis/mortality/physiopathology MH - Heart Rate/*physiology MH - Humans MH - Hypertension/physiopathology MH - Male MH - Prognosis MH - Proportional Hazards Models MH - Risk Factors MH - Statistics as Topic MH - Stroke Volume/physiology OTO - NOTNLM OT - Atrial fibrillation OT - Heart failure OT - Heart rate OT - Preserved ejection fraction OT - Prognosis FIR - Berry, C IR - Berry C FIR - Doughty, R IR - Doughty R FIR - Granger, C IR - Granger C FIR - Kober, L IR - Kober L FIR - Massie, B IR - Massie B FIR - McAlister, F IR - McAlister F FIR - McMurray, J IR - McMurray J FIR - Pocock, S IR - Pocock S FIR - Poppe, K IR - Poppe K FIR - Swedberg, K IR - Swedberg K FIR - Somaratne, J IR - Somaratne J FIR - Whalley, G IR - Whalley G FIR - Ahmed, A IR - Ahmed A FIR - Andersson, B IR - Andersson B FIR - Bayes-Genis, A IR - Bayes-Genis A FIR - Berry, C IR - Berry C FIR - Cowie, M IR - Cowie M FIR - Cubbon, R IR - Cubbon R FIR - Doughty, R IR - Doughty R FIR - Ezekowitz, J IR - Ezekowitz J FIR - Gonzalez-Juanatey, J IR - Gonzalez-Juanatey J FIR - Gorini, M IR - Gorini M FIR - Gotsman, I IR - Gotsman I FIR - Grigorian-Shamagian, L IR - Grigorian-Shamagian L FIR - Guazzi, M IR - Guazzi M FIR - Kearney, M IR - Kearney M FIR - Kober, L IR - Kober L FIR - Komajda, M IR - Komajda M FIR - di Lenarda, A IR - di Lenarda A FIR - Lenzen, M IR - Lenzen M FIR - Lucci, D IR - Lucci D FIR - Macin, S IR - Macin S FIR - Madsen, B IR - Madsen B FIR - Maggioni, A IR - Maggioni A FIR - Martinez-Selles, M IR - Martinez-Selles M FIR - McAlister, F IR - McAlister F FIR - Oliva, F IR - Oliva F FIR - Poppe, K IR - Poppe K FIR - Rich, M IR - Rich M FIR - Richards, M IR - Richards M FIR - Senni, M IR - Senni M FIR - Squire, I IR - Squire I FIR - Taffet, G IR - Taffet G FIR - Tarantini, L IR - Tarantini L FIR - Tribouilloy, C IR - Tribouilloy C FIR - Troughton, R IR - Troughton R FIR - Tsutsui, H IR - Tsutsui H FIR - Whalley, G IR - Whalley G FIR - Doughty, R IR - Doughty R FIR - Earle, N IR - Earle N FIR - Gamble, G D IR - Gamble GD FIR - Poppe, K IR - Poppe K FIR - Whalley, G IR - Whalley G FIR - Ariti, C IR - Ariti C FIR - Dobson, J IR - Dobson J FIR - Gamble, G D IR - Gamble GD FIR - Pocock, S IR - Pocock S FIR - Poppe, K IR - Poppe K FIR - Doughty, R N IR - Doughty RN FIR - Whalley, G IR - Whalley G FIR - Andersson, B IR - Andersson B FIR - Hall, C IR - Hall C FIR - Richards, A M IR - Richards AM FIR - Troughton, R IR - Troughton R FIR - Lainchbury, J IR - Lainchbury J FIR - Berry, C IR - Berry C FIR - Hogg, K IR - Hogg K FIR - Norrie, J IR - Norrie J FIR - Stevenson, K IR - Stevenson K FIR - Brett, M IR - Brett M FIR - McMurray, J IR - McMurray J FIR - Pfeffer, M A IR - Pfeffer MA FIR - Swedberg, K IR - Swedberg K FIR - Granger, C B IR - Granger CB FIR - Held, P IR - Held P FIR - McMurray, J J V IR - McMurray JJ FIR - Michelson, E L IR - Michelson EL FIR - Olofsson, B IR - Olofsson B FIR - Ostergren, J IR - Ostergren J FIR - Yusuf, S IR - Yusuf S FIR - Kober, L IR - Kober L FIR - Torp-Pedersen, C IR - Torp-Pedersen C FIR - Ahmed, Ali IR - Ahmed A FIR - Lenzen, M J IR - Lenzen MJ FIR - Scholte op Reimer, W J M IR - Scholte op Reimer WJ FIR - Boersma, E IR - Boersma E FIR - Vantrimpont, P J M J IR - Vantrimpont PJ FIR - Follath, F IR - Follath F FIR - Swedberg, K IR - Swedberg K FIR - Cleland, J IR - Cleland J FIR - Komajda, M IR - Komajda M FIR - Gotsman, I IR - Gotsman I FIR - Zwas, D IR - Zwas D FIR - Planer, D IR - Planer D FIR - Azaz-Livshits, T IR - Azaz-Livshits T FIR - Admon, D IR - Admon D FIR - Lotan, C IR - Lotan C FIR - Keren, A IR - Keren A FIR - Grigorian-Shamagian, L IR - Grigorian-Shamagian L FIR - Varela-Roman, A IR - Varela-Roman A FIR - Mazon-Ramos, P IR - Mazon-Ramos P FIR - Rigeiro-Veloso, P IR - Rigeiro-Veloso P FIR - Bandin-Dieguez, M A IR - Bandin-Dieguez MA FIR - Gonzalez-Juanatey, J R IR - Gonzalez-Juanatey JR FIR - Guazzi, M IR - Guazzi M FIR - Myers, J IR - Myers J FIR - Arena, R IR - Arena R FIR - McAlister, F A IR - McAlister FA FIR - Ezekowitz, J IR - Ezekowitz J FIR - Armstrong, P W IR - Armstrong PW FIR - Cujec, Bibiana IR - Cujec B FIR - Paterson, Ian IR - Paterson I FIR - Cowie, M R IR - Cowie MR FIR - Wood, D A IR - Wood DA FIR - Coats, A J S IR - Coats AJ FIR - Thompson, S G IR - Thompson SG FIR - Suresh, V IR - Suresh V FIR - Poole-Wilson, P A IR - Poole-Wilson PA FIR - Sutton, G C IR - Sutton GC FIR - Martinez-Selles, M IR - Martinez-Selles M FIR - Robles, J A G IR - Robles JA FIR - Prieto, L IR - Prieto L FIR - Munoa, M D IR - Munoa MD FIR - Frades, E IR - Frades E FIR - Diaz-Castro, O IR - Diaz-Castro O FIR - Almendral, J IR - Almendral J FIR - Registry, H F IR - Registry HF FIR - Tarantini, L IR - Tarantini L FIR - Faggiano, P IR - Faggiano P FIR - Senni, M IR - Senni M FIR - Lucci, D IR - Lucci D FIR - Bertoli, D IR - Bertoli D FIR - Porcu, M IR - Porcu M FIR - Opasich, C IR - Opasich C FIR - Tavazzi, L IR - Tavazzi L FIR - Maggioni, A P IR - Maggioni AP FIR - Kirk, V IR - Kirk V FIR - Bay, M IR - Bay M FIR - Parner, J IR - Parner J FIR - Krogsgaard, K IR - Krogsgaard K FIR - Herzog, T M IR - Herzog TM FIR - Boesgaard, S IR - Boesgaard S FIR - Hassager, C IR - Hassager C FIR - Nielsen, O W IR - Nielsen OW FIR - Aldershvile, J IR - Aldershvile J FIR - Kober, H Nielsen L IR - Kober HN FIR - Macin, S M IR - Macin SM FIR - Perna, E R IR - Perna ER FIR - Cimbaro Canella, J P IR - Cimbaro Canella JP FIR - Alvarenga, P IR - Alvarenga P FIR - Pantich, R IR - Pantich R FIR - Rios, N IR - Rios N FIR - Farias, E F IR - Farias EF FIR - Badaracco, J R IR - Badaracco JR FIR - Madsen, B K IR - Madsen BK FIR - Hansen, J F IR - Hansen JF FIR - Stokholm, K H IR - Stokholm KH FIR - Brons, J IR - Brons J FIR - Husum, D IR - Husum D FIR - Mortensen, L S IR - Mortensen LS FIR - Bayes-Genis, A IR - Bayes-Genis A FIR - Vazquez, R IR - Vazquez R FIR - Puig, T IR - Puig T FIR - Fernandez-Palomeque, C IR - Fernandez-Palomeque C FIR - Bardaji, A IR - Bardaji A FIR - Pascual-Figal, D IR - Pascual-Figal D FIR - Ordonez-Llanos, J IR - Ordonez-Llanos J FIR - Valdes, M IR - Valdes M FIR - Gabarrus, A IR - Gabarrus A FIR - Pavon, R IR - Pavon R FIR - Pastor, L IR - Pastor L FIR - Gonzalez-Juanatey, J R IR - Gonzalez-Juanatey JR FIR - Almendral, J IR - Almendral J FIR - Fiol, M IR - Fiol M FIR - Nieto, V IR - Nieto V FIR - Macaya, C IR - Macaya C FIR - Cinca, J IR - Cinca J FIR - Cygankiewitz, I IR - Cygankiewitz I FIR - Bayes de Luna, A IR - Bayes de Luna A FIR - Newton, J D IR - Newton JD FIR - Blackledge, H M IR - Blackledge HM FIR - Squire, I B IR - Squire IB FIR - Wright, S P IR - Wright SP FIR - Whalley, G A IR - Whalley GA FIR - Doughty, R N IR - Doughty RN FIR - Kerzner, R IR - Kerzner R FIR - Gage, B F IR - Gage BF FIR - Freedland, K E IR - Freedland KE FIR - Rich, M W IR - Rich MW FIR - Huynh, B C IR - Huynh BC FIR - Rovner, A IR - Rovner A FIR - Freedland, K E IR - Freedland KE FIR - Carney, R M IR - Carney RM FIR - Rich, M W IR - Rich MW FIR - Taffet, G E IR - Taffet GE FIR - Teasdale, T A IR - Teasdale TA FIR - Bleyer, A J IR - Bleyer AJ FIR - Kutka, N J IR - Kutka NJ FIR - Luchi, R J IR - Luchi RJ FIR - Tribouilloy, C IR - Tribouilloy C FIR - Rusinaru, D IR - Rusinaru D FIR - Mahjoub, H IR - Mahjoub H FIR - Souliere, V IR - Souliere V FIR - Levy, F IR - Levy F FIR - Peltier, M IR - Peltier M FIR - Tsutsui, H IR - Tsutsui H FIR - Tsuchihashi, M IR - Tsuchihashi M FIR - Takeshita, A IR - Takeshita A FIR - MacCarthy, P A IR - MacCarthy PA FIR - Kearney, M T IR - Kearney MT FIR - Nolan, J IR - Nolan J FIR - Lee, A J IR - Lee AJ FIR - Prescott, R J IR - Prescott RJ FIR - Shah, A M IR - Shah AM FIR - Brooksby, W P IR - Brooksby WP FIR - Fox, K A A IR - Fox KA FIR - Varela-Roman, A IR - Varela-Roman A FIR - Gonzalez-Juanatey, J R IR - Gonzalez-Juanatey JR FIR - Basante, P IR - Basante P FIR - Trillo, R IR - Trillo R FIR - Garcia-Seara, J IR - Garcia-Seara J FIR - Martinez-Sande, J L IR - Martinez-Sande JL FIR - Gude, F IR - Gude F EDAT- 2015/09/12 06:00 MHDA- 2016/10/08 06:00 CRDT- 2015/09/12 06:00 PHST- 2015/03/27 00:00 [received] PHST- 2015/07/15 00:00 [revised] PHST- 2015/07/19 00:00 [accepted] PHST- 2015/09/12 06:00 [entrez] PHST- 2015/09/12 06:00 [pubmed] PHST- 2016/10/08 06:00 [medline] AID - 10.1002/ejhf.346 [doi] PST - ppublish SO - Eur J Heart Fail. 2015 Nov;17(11):1182-91. doi: 10.1002/ejhf.346. Epub 2015 Sep 11.