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Background Elevated resting heart rate is known to be detrimental to morbidity and mortality in cardiovascular disease, though its effect in patients with ischemic stroke is unclear. We analyzed the effect of baseline resting heart rate on myocardial infarction (MI) in patients with a recent noncardioembolic cerebral ischemic event participating in PERFORM. Methods We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate < 70 bpm (n = 8178) or ≥ 70 bpm (n = 10 802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored. Results Heart rate ≥ 70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95% CI 1.03-1.69, P = 0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3%, P = 0.0002). Heart rate ≥ 70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P < 0001); vascular death (P < 0001); all-cause mortality (P < 0001); and fatal or nonfatal stroke (P = 0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7%, P < 0.0001), vascular death (11.0%, P < 0.0001), all-cause mortality (8.0%, P < 0.0001), and fatal and nonfatal stroke (2.4%, P = 0.057). Conclusion Elevated heart rate ≥ 70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI. © 2013 Elsevier Ireland Ltd.

Original publication

DOI

10.1016/j.ijcard.2013.04.206

Type

Journal article

Journal

International Journal of Cardiology

Publication Date

09/10/2013

Volume

168

Pages

3500 - 3505