Does heart rate predict the success of percutaneous coronary intervention?

This study investigated if heart rate can predict the success following a percutaneous coronary intervention (PCI).

They found that a higher heart rate (HR) before PCI was linked to a short-term risk of major adverse cardiac events (MACE; stroke, heart attack or death due to heart disease).

Coronary artery disease (CAD) is caused by reduced blood flow to the heart. The coronary arteries supply the heart with blood so that it can function and pump blood around the body. Blockages in the coronary arteries are caused by CAD. This reduces blood flow and can lead to heart failure (HF).

Percutaneous coronary intervention (PCI) is a surgical procedure used to treat CAD. PCI is minimally invasive and removes blockages in the arteries. Some patients recover well following PCI, however, some do not. It may be useful to identify factors that predict if PCI will be successful. Heart rate (HR) is associated with cardiovascular mortality (death due to heart/circulatory system events). It is unclear if HR may also be associated with complications after PCI.

This study included 3,720 patients who underwent PCI. Each patient had a HR recording before PCI. Follow-up was performed 30 days after PCI. All events were included in the analysis such as death, heart attack or stroke. Heart rate was categorized into 5 brackets, from low to high.

The rates of in-hospital heart failure, stroke and death were higher in patients with higher HR before PCI. The rate of MACE was higher with increased heart rate (from 2.4% in the lowest HR bracket to 4.7% in the highest bracket). HR was a significant predictor of MACE but not mortality 30 days post-PCI. 

The authors concluded that a higher heart rate before PCI was linked to a short-term risk of major adverse cardiac events.

The number of patients with congestive heart failure was low in this study. This may underestimate the relationship between HR and MACE.