TY - JOUR
T1 - Admission Heart Rate Predicts Poor Outcomes in Acute Intracerebral Hemorrhage
T2 - The Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Studies
AU - Qiu, Miaoyan
AU - Sato, Shoichiro
AU - Zheng, Danni
AU - Wang, Xia
AU - Carcel, Cheryl
AU - Hirakawa, Yoichiro
AU - Sandset, Else C.
AU - Delcourt, Candice
AU - Arima, Hisatomi
AU - Wang, Jiguang
AU - Chalmers, John
AU - Anderson, Craig S.
N1 - Funding Information:
Sources of Funding: The INTERACT studies were funded by the National Health and Medical Research Council of Australia.
Publisher Copyright:
© 2016 American Heart Association, Inc.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background and Purpose - Faster heart rate predicts higher mortality in coronary heart disease and acute ischemic stroke, but its prognostic significance in intracerebral hemorrhage remains uncertain. We aimed to determine the effect of admission heart rate on clinical and imaging outcomes in patients with intracerebral hemorrhage. Methods - A post hoc pooled analysis of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT 1 and 2). Clinical outcomes were mortality and modified Rankin Scale score at 90 days; and imaging outcome was absolute growth in hematoma volume during the initial 24 hours. Patients were divided into 4 categories according to baseline heart rate (<65, 65-74, 75-84, and ≥85 bpm) and analyzed using multivariable adjusted models with the lowest heart rate group as the reference. Results - Of 3185 patients with available data, higher admission heart rate was associated with both mortality and worse modified Rankin Scale score: adjusted hazard ratio for heart rate (≥85 versus <65 bpm) 1.50 (95% confidence interval, 1.07-2.11) and adjusted odds ratio 1.33 (95% confidence interval, 1.08-1.63), respectively (both P-trend <0.05). There was no significant relationship between heart rate and absolute growth in hematoma volume (P-trend, 0.196). Conclusions - Higher admission heart rate is independently associated with death and poor functional outcome after acute intracerebral hemorrhage. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079.
AB - Background and Purpose - Faster heart rate predicts higher mortality in coronary heart disease and acute ischemic stroke, but its prognostic significance in intracerebral hemorrhage remains uncertain. We aimed to determine the effect of admission heart rate on clinical and imaging outcomes in patients with intracerebral hemorrhage. Methods - A post hoc pooled analysis of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT 1 and 2). Clinical outcomes were mortality and modified Rankin Scale score at 90 days; and imaging outcome was absolute growth in hematoma volume during the initial 24 hours. Patients were divided into 4 categories according to baseline heart rate (<65, 65-74, 75-84, and ≥85 bpm) and analyzed using multivariable adjusted models with the lowest heart rate group as the reference. Results - Of 3185 patients with available data, higher admission heart rate was associated with both mortality and worse modified Rankin Scale score: adjusted hazard ratio for heart rate (≥85 versus <65 bpm) 1.50 (95% confidence interval, 1.07-2.11) and adjusted odds ratio 1.33 (95% confidence interval, 1.08-1.63), respectively (both P-trend <0.05). There was no significant relationship between heart rate and absolute growth in hematoma volume (P-trend, 0.196). Conclusions - Higher admission heart rate is independently associated with death and poor functional outcome after acute intracerebral hemorrhage. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079.
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U2 - 10.1161/STROKEAHA.115.012382
DO - 10.1161/STROKEAHA.115.012382
M3 - Article
C2 - 27165954
AN - SCOPUS:84966708493
VL - 47
SP - 1479
EP - 1485
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 6
ER -