ASSOCIATION OF HEART RATE AT HOSPITAL DISCHARGE AND REHOSPITALIZATION OF PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION

Authors

  • Kaleem Ullah Sheikh Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan
  • Abeer Sarfaraz Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan
  • Amna Janjua Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan
  • Sana Sarfaraz Department of Pharmacy and Pharmaceutical Sciences, University of Karachi-Pakistan
  • Sana Shoaib Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan
  • Sanjna Devi Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-12285

Abstract

Background: One of the major causes of cardiovascular morbidity and mortality is heart failure. The study aims to assess the effect of heart rate on the incidence of rehospitalization in patients with heart failure and reduced ejection fraction. Methods: It is a cross-sectional, analytical research conducted over six months, from June to December 2022, at the cardiology department of a tertiary care hospital. Patients who satisfied the modified Framingham heart failure criteria at admission and were discharged with an initial diagnosis of heart failure and those readmitted within 6 months or less of their discharge were included in the study. Pregnant women, patients diagnosed with cognitive impairment, and patients who had contraindications for taking any of the beta-blockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker /angiotensin receptor -neprilysin inhibitor, Sodium-Glucose co-transport inhibitor, and mineralocorticoid inhibitors were excluded from the study. Result: A total of 77 patients were included in the study. At discharge, approximately 71 patients had a heart rate of less than 70 beats/min and had no readmissions whereas, 6 patients had a heart rate of greater than 70 beats/min with 5 patients requiring readmission in the following 6 months. This relationship was statistically significant with a p-value of 0.000. Conclusion: According to the study, heart rate is a significant factor in the rehospitalization of individuals with heart failure and a low ejection fraction. At discharge, if the heart rate is not optimized then the rate of readmissions is increased.

Author Biographies

Kaleem Ullah Sheikh, Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

 

Abeer Sarfaraz, Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

 

Amna Janjua, Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

 

Sana Sarfaraz, Department of Pharmacy and Pharmaceutical Sciences, University of Karachi-Pakistan

 

Sana Shoaib, Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

 

Sanjna Devi, Department of Cardiology, Liaquat National Hospital and Medical College, Karachi-Pakistan

 

References

Suksatan W. Ascertainment of rehospitalization in patients with heart failure. J Ayub Med Coll Abbottabad 2020;32(4):583–4.

White-Williams C, Rossi LP, Bittner VA, Driscoll A, Durant RW, Granger BB, et al. Addressing social determinants of health in the care of patients with heart failure: a scientific statement from the American Heart Association. Circulation 2020;141(22):e841–63.

Ma C. Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: A longitudinal observational study. J Clin Nurs 2019;28(13-14):2526–36.

Cardoso J, Espíndola MD, Cunha M, Netto E, Cardoso C, Novaes M, et al. Is Current Drug Therapy for Heart Failure Sufficient to Control Heart Rate of Patients? Arq Bras Cardiol 2021;115(6):1063–9.

Tian J, Yan J, Zhang Q, Yang H, Chen X, Han Q, et al. Analysis of Re-Hospitalizations for Patients with Heart Failure Caused by Coronary Heart Disease: Data of First Event and Recurrent Event. Ther Clin Risk Manag 2019;15:1333–41.

Yumita Y, Nagatomo Y, Takei M, Saji M, Goda A, Kohno T, et al. Personalized target heart rate for patients with heart failure and reduced ejection fraction. J Pers Med 2022;12(1):50.

Yamaguchi T, Kitai T, Miyamoto T, Kagiyama N, Okumura T, Kida K, et al. Effect of optimizing guideline-directed medical therapy before discharge on mortality and heart failure readmission in patients hospitalized with heart failure with reduced ejection fraction. Am J Cardiol 2018;121(8):969–74.

Tay WT, Teng TK, Simon O, Ouwerkerk W, Tromp J, Doughty RN, et al. Readmissions, death and its associated predictors in heart failure with preserved versus reduced ejection fraction. J Am Heart Assoc 2021;10(22):e021414.

Löfström U, Hage C, Savarese G, Donal E, Daubert JC, Lund LH, et al. Prognostic impact of Framingham heart failure criteria in heart failure with preserved ejection fraction. ESC Heart Fail 2019;6(4):830–9.

Lopez-Vilella R, Marques-Sule E, Laymito Quispe RDP, Sánchez-Lázaro I, Donoso Trenado V, Martínez Dolz L, et al. The Female Sex Confers Different Prognosis in Heart Failure: Same Mortality but More Readmissions. Front Cardiovasc Med 2021;8:618398.

Akkineni SS, Mohammed O, Pathiraj JP, Devasia T, Chandrababu R, Kunhikatta V. Readmissions, and clinical outcomes in heart failure patients: a retrospective study. Clin Epidemiol Glob Health 2020;8(2):495–500.

Kurgansky KE, Schubert P, Parker R, Djousse L, Riebman JB, Gagnon DR, et al. Association of pulse rate with outcomes in heart failure with reduced ejection fraction: a retrospective cohort study. BMC Cardiovasc Disord 2020;20(1):92.

Palazzuoli A, Evangelista I, Ruocco G, Lombardi C, Giovannini V, Nuti R, et al. Early readmission for heart failure: An avoidable or ineluctable debacle. Int J Cardiol 2019;277:186–95.

Vollmert T, Hellmich M, Gassanov N, Er F, Yücel S, Erdmann E, et al. Heart rate at discharge in patients with acute decompensated heart failure is a predictor of mortality. Eur J Med Res 2020;25(1):47.

Faragli A, Tano GD, Carlini CD, Nassiacos D, Gori M, Confortola G, et al. In-hospital heart rate reduction with beta blockers and ivabradine early after recovery in patients with acute decompensated heart failure reduces short-term mortality and rehospitalization. Front Cardiovasc Med 2021;8:665202.

Oliva F, Sormani P, Contri R, Campana C, Carubelli V, Cirò A, et al. Heart rate as a prognostic marker and therapeutic target in acute and chronic heart failure. Int J Cardiol 2018;253:97–104.

Di Mauro M, Petroni R, Clemente D, Foschi M, Tancredi F, Camponetti V, et al. Clinical profile of patients with heart failure can predict rehospitalization and quality of life. J Cardiovasc Med 2018;19(3):98–104.

Chan JC, Cowley E, Chan M. Practical Pharmacological Treatment of Heart Failure: Does Ejection Fraction Matter Anymore? J Cardiovasc Dev Dis 2023;10(3):114

Docherty KF, Bayes-Genis A, Butler J, Coats AJS, Drazner MH, Joyce E, et al. The four pillars of HFrEF therapy: is it time to treat heart failure regardless of ejection fraction? Eur Heart J Suppl 2022;24(Suppl L):L10–9

Additional Files

Published

2023-12-22