Heart Rate and Cardiovascular Outcomes in Post-Myocardial Infarction Patients Treated by β-Blockers: A Secondary Analysis of the ABYSS Trial.
Michel Zeitouni, Niki Procopi, Guillaume Cayla et al.
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In 30 seconds
This secondary analysis of the ABYSS trial evaluated 3698 stable post-myocardial infarction patients to assess the relationship between heart rate (HR) and β-blocker interruption on cardiovascular outcomes. The study found that higher HR was associated with increased risks of death, myocardial infarction, or stroke, with an adjusted hazard ratio of 1.55 for the highest HR tertile compared to the lowest.
Key findings
- Higher HR was linked to increased risk of death, MI, or stroke (9.2% vs 5.5% in T3 vs T1; P <0.001).
- All-cause mortality increased across HR tertiles (5.9% vs 2.9% in T3 vs T1; P =0.004).
- β-Blocker interruption led to a dose-dependent HR increase of approximately 10-13 bpm during follow-up.
- The association between β-blocker interruption and worse outcomes was consistent across HR tertiles.
Why it matters
Understanding the relationship between heart rate and cardiovascular outcomes in post-myocardial infarction patients is crucial for optimizing treatment strategies. This study highlights the importance of maintaining β-blocker therapy to mitigate risks associated with higher heart rates.