The relationship between heart rate and mortality of patients with acute coronary syndromes in the coronary intervention era: Meta-analysis.

Background: Most of acute coronary syndromes (ACS) were receiving intervention treatment a high overall rate of coronary angiography in the modern medical practice. Consequently, we conduct a review to determine the heart rate (HR) on the prognosis of ACS in the coronary intervention era. Methods: PubMed, EMBASE, MEDLINE, and the Cochrane Library was systematically searched up to May 2016 using the search terms "heart rate," "acute coronary syndrome," "acute myocardial infarction," "ST-elevation myocardial infarction," "non-ST-segment elevation." The outcome of interest was all-cause mortality. All analyses were performed using Review Manager. Results: Database searches retrieved 2324 citations. Eleven studies enrolling 156,374 patients were included. In-hospital mortality was significantly higher in the elevated HR group compared to the lower HR group (pooled RR 2.04, 95% CI 1.80-2.30, P<0.0001). Individuals with elevated admission HR had increased risk of long-term mortality (Pooled RR=1.63, 95% CI 1.27-2.10, P=0.008) compared to lower admission HR. The pooled results showed elevated discharge and resting HR were related to increased mortality of patients with ACS (pooled RR 1.88, 95% CI 1.02-3.47, P=0.04; pooled RR 2.14, 95% CI 1.37-3.33, P<0.0001, respectively). Conclusion: Elevated HR may increase the mortality of ACS patients in the percutaneous coronary intervention era.