Objective: To explore the value of resting heart rate(RHR)in predicting the long-term prognosis of patients with acute myocardial infarction(AMI) complicated with heart failure(HF) undergoing percutaneous coronary intervention(PCI). Methods: A total of 120 patients with AMI complicated with HF treated in the Department of Cardiology of Xingtai Third Hospitalbetween August 2013 and August 2014 were selected as subjects of our study. The subjects were divided into groups A, B, C and D based on RHR levels at admission: ≤ 73, 74-81, 82-90, and ≥ 91 times·min-1 respectively. All patients were followed up for 5 years, and information of all-cause death and MACE patients was recorded. Multivariate Logistic regression analysis was used to screen the independent predictors of all-cause death and major adverse cardiovascular events(MACE). The Kaplan-Meier survival curve was used to analyze the survival rates of all-cause death and MACE in four groups. The receiver working characteristic(ROC) curve was used to evaluate the prognosis of RHR and the diagnostic value of all-cause death and MACE.Results: Multivariate Logistic regression analysis showed that age, low density lipoprotein cholesterol(LDL-C), left ventricular ejection fraction(LVEF), RHR and Gensini score were independent predictors of all-cause death, while age, LDL-C level, LVEF, RHR, New York Heart Association(NYHA) cardiac function grade and Gensini score were independent predictors of MACE. The all-cause mortality and the incidence of MACE in the four groups increased with increasing RHR, and the effect was statistically significant(all P<0.05). For all-cause deaths, there was significant difference in cardiac death among the four groups(P<0.05), but no significant difference in non-cardiac death(P<0.05). In the occurrence of MACE, there was significant difference in the incidence of myocardial infarction among the four groups(P<0.05), but no significant difference in other MACE(all P<0.05). The Kaplan-Meier survival curve revealed significant differences in all-cause death and MACE survival rate among the four groups(all P<0.05). The survival rate in group D was significantly lower than that in group A and group B(P<0.05). The ROC curve showed that the area under the curve of RHR for AMI patients with HF after PCI was 0.872 and the optimal cut-off value was 91 times·min-1, while the area under the curve of MACE was 0.813 and the optimal cut-off value was 86 times·min-1, both of which had high diagnostic value.Conclusion: RHR is an independent predictor of long-term prognosis of all-cause death and MACE in patients with AMI combined with HF after PCI treatment, and has high diagnostic and clinical reference value.
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