In-hospital heart rate reduction and its relation to outcomes of heart failure patients with sinus rhythm: Results from the Polish part of the European Society of Cardiology Heart Failure Pilot and Long-Term Registries

Background: Currently, there is no information on whether in-hospital heart rate (HR) reduction has an influence on risk of death or rehospitalization. The study evaluates the relation between inhospital HR reduction in heart failure (HF) patients on mortality and rehospitalization within 1-year observation. Methods: The analysis included patients hospitalized in Poland with sinus rhythm from the European Society of Cardiology Heart Failure Pilot (ESC-HF-Pilot) and ESC Heart Failure Long-Term Registries (ESC-HF-LT), who were divided into two groups: reduced HR and not-reduced HR. HR reduction was defined as a reduced value of HR at discharge compared to admission HR. The primary endpoint was 1-year all-cause death, the secondary endpoint was 1-year all-cause death or rehospitalization for worsening HF. Results: The final analysis included 747 patients; 491 reduced HR (65.7%) and 256 not-reduced HR (34.3%). The primary endpoint occurred in 58/476 (122%) from reduced HR group and in 26/246 (10.5%) from not-reduced HR group (p = 0.54). In the reduced HR group, independent predictors of primary endpoint were age, New York Heart Association class at admission, serum sodium level at admission and systolic blood pressure at discharge. In the not-reduced HR group the independent predictor of primary endpoint was diastolic blood pressure at discharge. The secondary endpoint was observed in .180 patients, 124/398 (312%) from reduced HR and 56/207 (27.1%) from the not-reduced HR group (p= 0.30). In the not-reduced HR group only angiotensin converting-enzyme inhibitor usage at discharge was independently associated with lower risk of the secondary endpoint. Conclusions: In-hospital HR reduction did not influence on the outcomes of HF patients in sinus rhythm.