Inaguma D, et al. - Given an association has been shown between resting heart rate and mortality in some observational studies of the general population, researchers attempted to clarify this link in dialysis patients. They found an association between resting heart rate just before starting the first dialysis session and all-cause mortality after dialysis initiation.

Methods

• In this multicentre prospective cohort analysis including 1102 patients, based on resting heart rate just before starting the first dialysis session the following 4 groups were identified: <60/min; 60–79/min; 80–100/min; and ≥101/min.
• Using the log-rank test, all-cause mortality, cardiovascular (CV) related mortality, and incidences of CV events after dialysis initiation were compared.
• Researchers used multivariate Cox proportional hazard regression analysis to assess all-cause mortality rates for patients with heart rates <60, 60–79, and ≥101/min compared to those for patients with heart rates 80–100/min.
• They also compared the outcomes among patients without use of β-blocker or heart failure symptom at the first dialysis session.

Results

• Among the four groups, the all-cause mortality rates differed significantly (P=0.007).
• In multivariate analysis, significantly higher all-cause mortality was found in patients with heart rate ≥ 101/min vs in patients with heart rate 80–100/min (hazard ratio [HR] = 2.30, 95% confidence interval [CI]: 1.25–4.23).
• In subgroup analysis, among patients without use of b-blocker or heart failure symptom, significantly higher all-cause mortality rates were observed for those with heart rates ≥101/min vs in patients with heart rate 80–100/min (HR = 2.98, 95% CI: 1.51–5.88, HR = 3.65, 95% CI: 1.59–8.36, respectively).