ハタ　タケヒロ   Hata Takehiro   秦　武弘    所属   医学部 医学科（東京女子医科大学病院）    職種   助手
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prognostically Optimal Heart Rate at Discharge in Hospitalized Patients With Heart Failure and Atrial Fibrillation.
掲載誌名	正式名：JACC. Advances 略　 称：JACC Adv ISSNコード：2772963X/2772963X
掲載区分	国外
巻・号・頁	3(8),pp.101120
著者・共著者	Kishihara Makoto, Kawakami Ryoko, Fukushima Noritoshi, Abe Takuro, Takada Takuma, Shirotani Shota, Yoshida Ayano, Hata Takehiro, Watanabe Shonosuke, Kawamoto Takanori, Hasegawa Shun, Yamaguchi Junichi, Jujo Kentaro
発行年月	2024/08
概要	BACKGROUND:Managing heart rate (HR) is crucial for enhancing clinical prognosis in patients with heart failure (HF) and atrial fibrillation (AF). Nevertheless, the prognostic impact of HR at discharge in hospitalized HF patients remains unclear.OBJECTIVES:This study aimed to determine the HR associated with the lowest risk of death and HF in patients hospitalized with HF and AF.METHODS:In this observational study, 334 persistent AF patients were analyzed from a database of 1,930 consecutive HF hospitalizations. Exclusion criteria included sinus rhythm or paroxysmal AF, cardiac pacemakers, or unrecorded HR at discharge. Participants were divided into four groups based on HR at discharge in 10 beats/min increments. The primary endpoint was a composite of death from any cause and rehospitalization due to HF. The association between resting HR and the primary endpoint was determined using Kaplan-Meier analysis and Cox proportional hazards models.RESULTS:The median follow-up period was 389 days, with 133 patients (39.8%) reaching the primary endpoint. Kaplan-Meier analysis revealed a significantly higher primary endpoint incidence in patients with HR >81 beats/min at discharge compared to those with HR <60 beats/min (log-rank test for trend: P = 0.039). Multivariable Cox regression analysis showed that HR >81 beats/min at discharge was associated with the primary endpoint, with a hazard ratio of 1.79 (95% CI: 1.04-3.07), compared to HR <60 beats/min.CONCLUSIONS:The findings suggest that controlling HR to less than 80 beats/min at discharge may lead to better clinical outcomes in patients with HF and persistent AF.
DOI	10.1016/j.jacadv.2024.101120
PMID	39156115