ジユウジヨウ　ケンタロウ   Jiyuujiyou Kentarou   重城　健太郎    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
言語種別	英語
発表タイトル	Makoto Kishihara, Kentaro Jujo, Takuma Takada, Takuro Abe, Shota Shirotani, Nana Endo, Shonosuke Watanabe, Yuichiro Minami, Nobuhisa Hagiwara
会議名	第85回日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎Makoto Kishihara, Kentaro Jujo, Takuma Takada, Takuro Abe, Shota Shirotani, Nana Endo, Shonosuke Watanabe, Yuichiro Minami, Nobuhisa Hagiwara
発表年月日	2021/03/26
開催地 （都市, 国名）	奈良県 (ハイブリット開催)
概要	Introduction: Heart rate (HR) reduction is a key strategy for improving prognosis of patients with chronic heart failure (HF). However, the degree of HR reduction during hospitalization is strongly correlated with HR at admission, and the impact of in-hospital HR change on the prognosis after discharge in HF patients is still unclear. Methods: This observational study included 1,194 hospitalized HF patients who were discharged alive; 510 patients presented atrial fibrillation (AF), and 684 presented sinus rhythm (SR) at admission. They were respectively classified into 3 groups: (1) HR of ≥20% reduction, (2) HR of 0-20% reduction, and (3) HR of >0% increase at discharge from their admission. The primary endpoint was a composite of death from any cause after discharge and re-hospitalization due to HF. Results: Beta blocker was prescribed in 287 (56%) patients with AF and 363 (53%) with SR before admission (p=0.29). The primary endpoint developed 265 (52%) and 311 (45%) in the populations with AF and SR, respectively. In both populations, Kaplan-Meier analysis showed a lowest rate of a combined outcome in the HR of ≥20% reduction group (log-rank for trend: both p<0.05). After adjusting for age, sex, beta blocker, and HR at admission, HR reduction was still an independent predictor for a combined outcome in patients with AF [HR: 1.010, 95%CI: 1.002-1.017)]. However, this finding was not observed in patients with SR (HR: 1.006, 95%CI: 0.996-1.016). Conclusions: Higher HR reduction during hospitalization in HF patients with AF could lead to better clinical outcomes after discharge, but the benefit may be limited in patients with SR.