What is the clinical evidence from this study?

Study design: Observational. Population: ST-segment elevation myocardial infarction (STEMI) (n=309). Intervention: Admission heart rate (AHR) vs. Lower admission heart rate. Primary outcome: Adverse in-hospital cardiovascular events (acute heart failure, stroke, cardiovascular death, and non-cardiac death) (OR 1.033, 95% CI 1.008-1.060, p=<0.05).

What does this research mean for the field?

Elevated admission and 24-hour heart rates, but not first medical contact heart rate, are significant early predictors of adverse in-hospital cardiovascular outcomes in STEMI patients undergoing primary PCI. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate correlations between heart rates at initial contact, admission, and after 24 hours with in-hospital adverse outcomes in STEMI patients undergoing PPCI.

May 26, 2026BMC Cardiovascular Disorders0 citationsOpen Access

Admission and 24-hour heart rates and in-hospital outcomes in STEMI undergoing primary PCI

Q: What are the key findings of this study?

Every 1 bpm increase in admission heart rate was associated with a 3.3% increased risk of adverse in-hospital cardiovascular events in STEMI patients undergoing primary PCI (OR 1.033).

Q: What does this research mean for the field?

Elevated admission and 24-hour heart rates, but not first medical contact heart rate, are significant early predictors of adverse in-hospital cardiovascular outcomes in STEMI patients undergoing primary PCI. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

This study aims to evaluate correlations between heart rates at initial contact, admission, and after 24 hours with in-hospital adverse outcomes in STEMI patients undergoing PPCI.

YCYuke Cui ZXZhihong Xu XQXuezheng Qu

Key Result

Every 1 bpm increase in admission heart rate was associated with a 3.3% increased risk of adverse in-hospital cardiovascular events in STEMI patients undergoing primary PCI (OR 1.033).

Key Points

This study aims to evaluate correlations between heart rates at initial contact, admission, and after 24 hours with in-hospital adverse outcomes in STEMI patients undergoing PPCI.
Retrospective single-center observational study
Included 309 STEMI patients undergoing PPCI from September 2018 to December 2020
Analyzed heart rates using binary logistic regression models adjusted for various confounders
Higher admission heart rate (AHR) and 24-hour heart rate significantly associated with increased in-hospital CV events (OR: 1.033, 95% CI: 1.008–1.060; OR: 1.037, 95% CI: 1.003–1.071)
Every 5 bpm increase in AHR and 24-hour heart rate linked to an 18.6% and 19.8% elevated risk of in-hospital CV events respectively
First medical contact heart rate showed limited predictive value for these events

Study Design

Type

Observational (n=309)

Multicenter

Structured PICO

Does elevated admission or 24-hour heart rate predict adverse in-hospital cardiovascular outcomes in patients with STEMI undergoing primary PCI?

Population

309 consecutive adult patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), mean age 65.18, 77.7% male, single-center in China. Exclusions: cardiogenic shock, atrial fibrillation or rhythm disturbances precluding sinus-rhythm HR assessment, missing HR data.

Intervention

Elevated heart rate at hospital admission (AHR) and average sinus-rhythm heart rate during the first 24 hours of continuous ECG monitoring (24HR)

Comparator

Lower heart rate (lowest tertile used as reference)

Outcome

Composite of in-hospital adverse cardiovascular events (acute heart failure, stroke, cardiovascular death, and non-cardiac death)composite

Elevated admission and 24-hour heart rates are independent predictors of adverse in-hospital cardiovascular events, predominantly acute heart failure, in patients with STEMI undergoing primary PCI.

Main Result

Effect estimate: OR 1.033 (95% CI 1.008-1.060)

p-value: p=<0.05

Limitations

Retrospective single-center design in a relatively homogeneous Chinese population limits generalizability.
Exclusion of patients with missing HR measurements, cardiogenic shock, or arrhythmias may introduce selection bias.
Underpowered for reliable endpoint-specific multivariable analyses of hard clinical outcomes like stroke and death.
No long-term follow-up data available beyond hospitalization.
Lack of detailed information regarding pre-admission medications and timing of in-hospital medication initiation.
Potential for overfitting and residual confounding due to limited number of outcome events relative to covariates.

Abstract

Abstract Background Heart rate (HR) plays a central role in cardiac physiology and has been closely associated with major cardiovascular (CV) outcomes, including heart failure, ischemic heart disease, and cardiovascular mortality. However, whether HR can serve as an early predictor of in-hospital outcomes among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains unclear. This study aimed to evaluate the associations between heart rate at first medical contact (FHR), at hospital admission (AHR), and at 24 h post-admission (24 h) with adverse in-hospital outcomes. Methods This retrospective single-center observational study included 309 consecutive patients with STEMI who underwent PPCI between September 2018 and December 2020 at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Associations between the three HR measurements and in-hospital adverse cardiovascular events were analyzed using binary logistic regression models. Both crude models and models adjusted for conventional risk factors, biomarkers, and treatment variables were assessed. Results Both AHR and 24 h were positively associated with in-hospital CV events, predominantly acute heart failure ( P < 0.05), which were predominantly driven by acute heart failure. After adjusting for potential confounders, the odds of having in-hospital CV events were significantly enhanced by an increase in AHR and 24 h (odds ratio OR: 1.033, 95% confidence intervals CI: 1.008–1.060; OR: 1.037, 95% CI: 1.003–1.071, respectively). Additionally, every 5 bpm increase in AHR and 24 h was associated with an 18.6% and a 19.8% increased risk of in-hospital CV events, respectively. In contrast, FHR showed limited predictive value for such events. Conclusion Among STEMI patients undergoing PPCI, elevated admission and 24-hour heart rates are significantly associated with adverse in-hospital cardiovascular outcomes. Admission heart rate, in particular, may serve as a simple and reliable prognostic indicator for identifying patients at increased short-term risk.

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Cite This Study

Cui et al. (Mon,) conducted a observational in ST-segment elevation myocardial infarction (STEMI) (n=309). Admission heart rate (AHR) vs. Lower admission heart rate was evaluated on Adverse in-hospital cardiovascular events (acute heart failure, stroke, cardiovascular death, and non-cardiac death) (OR 1.033, 95% CI 1.008-1.060, p=<0.05). Every 1 bpm increase in admission heart rate was associated with a 3.3% increased risk of adverse in-hospital cardiovascular events in STEMI patients undergoing primary PCI (OR 1.033).

synapsesocial.com/papers/6a153b00b5d9c58d83e8d40e https://doi.org/https://doi.org/10.1186/s12872-026-06027-w

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