About: Heart Rate and Use of Beta-Blockers in Stable Outpatients with Coronary Artery Disease

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rdf:type	skos:Concept http://linked.opendata.cz/ontology/domain/vavai/Vysledek
Description	Background: Heart rate (HR) is an emerging risk factor in coronary artery disease (CAD). However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta-blockers, among patients with stable CAD in routine clinical practice. The goal of the present analysis was to describe HR in such patients, overall and in relation to beta-blocker use, and to describe the determinants of HR. Methods and Findings: CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis of >50%, or chest pain associated with proven myocardial ischemia. A total of 33,438 patients from 45 countries in Europe, the Americas, Africa, Middle East, and Asia/Pacific were enrolled between November 2009 and July 2010. Most of the 33,177 patients included in this analysis were men (77.5%). Mean (SD) age was 64.2 (10.5) years, HR by pulse was 68.3 (10.6) bpm, and by electrocardiogram was 67.2 (11.4) bpm. Overall, 44.0% had HR >= 70 bpm. Beta-blockers were used in 75.1% of patients and another 14.4% had intolerance or contraindications to beta-blocker therapy. Among 24,910 patients on beta-blockers, 41.1% had HR >= 70 bpm. HR >= 70 bpm was independently associated with higher prevalence and severity of angina, more frequent evidence of myocardial ischemia, and lack of use of HR-lowering agents. Conclusions: Despite a high rate of use of beta-blockers, stable CAD patients often have resting HR >= 70 bpm, which was associated with an overall worse health status, more frequent angina and ischemia. Further HR lowering is possible in many patients with CAD. Whether it will improve symptoms and outcomes is being tested. Background: Heart rate (HR) is an emerging risk factor in coronary artery disease (CAD). However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta-blockers, among patients with stable CAD in routine clinical practice. The goal of the present analysis was to describe HR in such patients, overall and in relation to beta-blocker use, and to describe the determinants of HR. Methods and Findings: CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis of >50%, or chest pain associated with proven myocardial ischemia. A total of 33,438 patients from 45 countries in Europe, the Americas, Africa, Middle East, and Asia/Pacific were enrolled between November 2009 and July 2010. Most of the 33,177 patients included in this analysis were men (77.5%). Mean (SD) age was 64.2 (10.5) years, HR by pulse was 68.3 (10.6) bpm, and by electrocardiogram was 67.2 (11.4) bpm. Overall, 44.0% had HR >= 70 bpm. Beta-blockers were used in 75.1% of patients and another 14.4% had intolerance or contraindications to beta-blocker therapy. Among 24,910 patients on beta-blockers, 41.1% had HR >= 70 bpm. HR >= 70 bpm was independently associated with higher prevalence and severity of angina, more frequent evidence of myocardial ischemia, and lack of use of HR-lowering agents. Conclusions: Despite a high rate of use of beta-blockers, stable CAD patients often have resting HR >= 70 bpm, which was associated with an overall worse health status, more frequent angina and ischemia. Further HR lowering is possible in many patients with CAD. Whether it will improve symptoms and outcomes is being tested. (en)
Title	Heart Rate and Use of Beta-Blockers in Stable Outpatients with Coronary Artery Disease Heart Rate and Use of Beta-Blockers in Stable Outpatients with Coronary Artery Disease (en)
skos:prefLabel	Heart Rate and Use of Beta-Blockers in Stable Outpatients with Coronary Artery Disease Heart Rate and Use of Beta-Blockers in Stable Outpatients with Coronary Artery Disease (en)
skos:notation	RIV/00064173:_____/12:43907019!RIV13-MZ0-00064173
http://linked.open...avai/riv/aktivita	N
http://linked.open...avai/riv/aktivity	N
http://linked.open...iv/cisloPeriodika	5
http://linked.open...vai/riv/dodaniDat	2013
http://linked.open...aciTvurceVysledku	Widimský, P.
http://linked.open.../riv/druhVysledku	J - Článek v odborném periodiku
http://linked.open...iv/duvernostUdaju	S - Úplné a pravdivé údaje nepodléhající ochraně podle zvláštních právních předpisů
http://linked.open...titaPredkladatele	Fakultní nemocnice Královské Vinohrady
http://linked.open...dnocenehoVysledku	138723
http://linked.open...ai/riv/idVysledku	RIV/00064173:_____/12:43907019
http://linked.open...riv/jazykVysledku	eng - angličtina
http://linked.open.../riv/klicovaSlova	angina; task-force; risk-factor; double-blind; subgroup analysis; external validity; i-f inhibitor; acute myocardial-infarction; ventricular systolic dysfunction; placebo-controlled trial (en)
http://linked.open.../riv/klicoveSlovo	acute myocardial-infarction angina double-blind task-force risk-factor i-f inhibitor subgroup analysis ventricular systolic dysfunction external validity placebo-controlled trial
http://linked.open...odStatuVydavatele	US - Spojené státy americké
http://linked.open...ontrolniKodProRIV	[643866EB70D2]
http://linked.open...i/riv/nazevZdroje	PLoS One
http://linked.open...in/vavai/riv/obor	FA
http://linked.open...ichTvurcuVysledku	1 (xsd:int)
http://linked.open...cetTvurcuVysledku	2610 (xsd:int)
http://linked.open...UplatneniVysledku	2012
http://linked.open...v/svazekPeriodika	7
http://linked.open...iv/tvurceVysledku	Widimský, Petr
http://linked.open...ain/vavai/riv/wos	000305343400015
issn	1932-6203
number of pages	8 (xsd:int)
http://bibframe.org/vocab/doi	10.1371/journal.pone.0036284

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