Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.

<h4>Background</h4>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 goa...

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Autores principales:	Ph Gabriel Steg, Roberto Ferrari, Ian Ford, Nicola Greenlaw, Jean-Claude Tardif, Michal Tendera, Hélène Abergel, Kim M Fox, CLARIFY Investigators
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2158c5199d7b4819ab00a35f107c5f4b
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spelling	oai:doaj.org-article:2158c5199d7b4819ab00a35f107c5f4b2021-11-18T07:19:45ZHeart rate and use of beta-blockers in stable outpatients with coronary artery disease.1932-620310.1371/journal.pone.0036284https://doaj.org/article/2158c5199d7b4819ab00a35f107c5f4b2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22570699/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.Ph Gabriel StegRoberto FerrariIan FordNicola GreenlawJean-Claude TardifMichal TenderaHélène AbergelKim M FoxCLARIFY InvestigatorsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 5, p e36284 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ph Gabriel Steg Roberto Ferrari Ian Ford Nicola Greenlaw Jean-Claude Tardif Michal Tendera Hélène Abergel Kim M Fox CLARIFY Investigators Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
description	<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.
format	article
author	Ph Gabriel Steg Roberto Ferrari Ian Ford Nicola Greenlaw Jean-Claude Tardif Michal Tendera Hélène Abergel Kim M Fox CLARIFY Investigators
author_facet	Ph Gabriel Steg Roberto Ferrari Ian Ford Nicola Greenlaw Jean-Claude Tardif Michal Tendera Hélène Abergel Kim M Fox CLARIFY Investigators
author_sort	Ph Gabriel Steg
title	Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
title_short	Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
title_full	Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
title_fullStr	Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
title_full_unstemmed	Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
title_sort	heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/2158c5199d7b4819ab00a35f107c5f4b
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Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.

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