Time-updated resting heart rate predicts mortality in patients with COPD

TY - JOUR

T1 - Time-updated resting heart rate predicts mortality in patients with COPD

AU - Omlor, Albert J

AU - Trudzinski, Franziska C

AU - Alqudrah, Mohamad

AU - Seiler, Frederik

AU - Biertz, Frank

AU - Vogelmeier, Claus F

AU - Welte, Tobias

AU - Watz, Henrik

AU - Waschki, Benjamin

AU - Brinker, Titus J

AU - Andreas, Stefan

AU - Fähndrich, Sebastian

AU - Alter, Peter

AU - Jörres, Rudolf A

AU - Böhm, Michael

AU - Bals, Robert

AU - German COSYCONET Cohort

PY - 2020/6/1

Y1 - 2020/6/1

N2 - High resting heart rate (RHR) is associated with higher mortality in the general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). In particular, the time-updated RHR (most recent value before the event) appears informative. This is the first study to investigate the association of time-updated RHR with mortality in COPD. We compared the baseline and time-updated RHR related to survival in 2218 COPD patients of the German COSYCONET cohort (COPD and Systemic Consequences-Comorbidities Network). Patients with a baseline RHR > 72 beats per minute (bmp) had a significantly (p = 0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00-1.87) compared to baseline RHR ≤ 72 bpm. The time-updated RHR > 72 bpm was markedly superior (HR 1.79, 1.30-2.46, p = 0.001). Both, increased baseline and time-updated RHR, were independently associated with low FEV1, low TLCO, a history of diabetes, and medication with short-acting beta agonists (SABAs). In conclusion, increased time-updated RHR is associated with higher mortality in COPD independent of other predictors and superior to baseline RHR. Increased RHR is linked to lung function, comorbidities and medication. Whether RHR is an effective treatment target in COPD, needs to be proven in controlled trials.

AB - High resting heart rate (RHR) is associated with higher mortality in the general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). In particular, the time-updated RHR (most recent value before the event) appears informative. This is the first study to investigate the association of time-updated RHR with mortality in COPD. We compared the baseline and time-updated RHR related to survival in 2218 COPD patients of the German COSYCONET cohort (COPD and Systemic Consequences-Comorbidities Network). Patients with a baseline RHR > 72 beats per minute (bmp) had a significantly (p = 0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00-1.87) compared to baseline RHR ≤ 72 bpm. The time-updated RHR > 72 bpm was markedly superior (HR 1.79, 1.30-2.46, p = 0.001). Both, increased baseline and time-updated RHR, were independently associated with low FEV1, low TLCO, a history of diabetes, and medication with short-acting beta agonists (SABAs). In conclusion, increased time-updated RHR is associated with higher mortality in COPD independent of other predictors and superior to baseline RHR. Increased RHR is linked to lung function, comorbidities and medication. Whether RHR is an effective treatment target in COPD, needs to be proven in controlled trials.

KW - Aged

KW - Cause of Death/trends

KW - Female

KW - Follow-Up Studies

KW - Germany/epidemiology

KW - Heart Rate/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive/mortality

KW - Rest/physiology

KW - Risk Factors

KW - Survival Rate/trends

KW - Time Factors

U2 - 10.1007/s00392-019-01572-1

DO - 10.1007/s00392-019-01572-1

M3 - SCORING: Journal article

C2 - 31734762

VL - 109

SP - 776

EP - 786

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 6

ER -