JUJO Kentaro    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Language	English
Title	Makoto Kishihara, Kentaro Jujo, Takuma Takada, Takuro Abe, Shota Shirotani, Nana Endo, Shonosuke Watanabe, Yuichiro Minami, Nobuhisa Hagiwara
Conference	第85回日本循環器学会学術集会
Conference Type	Nationwide Conferences
Presentation Type	Speech
Lecture Type	General
Publisher and common publisher	◎Makoto Kishihara, Kentaro Jujo, Takuma Takada, Takuro Abe, Shota Shirotani, Nana Endo, Shonosuke Watanabe, Yuichiro Minami, Nobuhisa Hagiwara
Date	2021/03/26
Venue (city and name of the country)	奈良県 (ハイブリット開催)
Summary	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.