Table 1
Characteristics of Participants According to Time in Target Range of Resting Heart Rate.
| VARIABLES MEAN ± SD OR n (%) | OVERALL (n = 3306) | TIR GROUP | |||
|---|---|---|---|---|---|
| 0%~50% (n = 662) | >50~75% (n = 454) | >75~100% (n = 2190) | P VALUE | ||
| Age | 70 ± 8 | 69 ± 8 | 69 ± 8 | 70 ± 8 | 0.046 |
| Gender | 0.632 | ||||
| Male | 2019 (61%) | 398 (60%) | 271 (60%) | 1350 (62%) | |
| Female | 1287 (39%) | 264 (40%) | 183 (40%) | 840 (38%) | |
| Minority | 0.861 | ||||
| Caucasian | 2976 (90%) | 599 (91%) | 410 (90%) | 1967 (90%) | |
| Non-Caucasian | 330 (10%) | 63 (10%) | 44 (10%) | 223 (10%) | |
| Smoking | <0.001 | ||||
| Non-smoker | 2927 (90%) | 557 (84%) | 397 (87%) | 1973 (90%) | |
| Smoking(within 2 years) | 379 (12%) | 105 (16%) | 57 (13%) | 217 (10%) | |
| Randomized treatment group | <0.001 | ||||
| Rate control | 1653 (50%) | 435 (66%) | 252 (56%) | 966 (44%) | |
| Rhythm control | 1653 (50%) | 227 (34%) | 202 (45%) | 1224 (56%) | |
| Hypertension | 2346 (71%) | 466 (70%) | 317 (70%) | 1563 (71%) | 0.753 |
| Diabetes mellitus | 645 (20%) | 149 (23%) | 107 (24%) | 389 (18%) | 0.002 |
| Coronary artery disease | 1234 (37%) | 234 (35%) | 165 (36%) | 835 (38%) | 0.387 |
| Pacemaker implantation | 194 (6%) | 32 (5%) | 28 (6%) | 134 (6%) | 0.448 |
| Coronary artery bypass graft | 407 (12%) | 72 (11%) | 56 (12%) | 279 (13%) | 0.441 |
| Interventional procedure | 282 (9%) | 45 (7%) | 30 (7%) | 207 (10%) | 0.029 |
| TIR, % | 77 ± 31 | 22 ± 17 | 64 ± 7 | 96 ± 6 | <0.001 |
| Mean RHR | 71 ± 10 | 84 ± 6 | 77 ± 4 | 65 ± 7 | <0.001 |
Table 2
Risk of Cardiovascular Outcomes for Time in Target Range of Resting Heart Rate.
| TIR | MODEL 1 | MODEL 2 | MODEL 3 | |||
|---|---|---|---|---|---|---|
| HR (95% CI) | p VALUE | HR (95% CI) | p VALUE | HR (95% CI) | p VALUE | |
| Major adverse cardiovascular events | ||||||
| 0%~50% | 1.59(1.32,1.91) | <0.001 | 1.56(1.30,1.88) | <0.001 | 1.56(1.30,1.88) | <0.001 |
| >50%~75% | 1.40(1.13,1.73) | 0.002 | 1.32(1.07,1.65) | 0.011 | 1.31(1.06,1.63) | 0.014 |
| >75%~100% | 1.00(Reference) | … | 1.00(Reference) | … | 1.00(Reference) | … |
| Per 1 SD | 0.83(0.77,0.89) | <0.001 | 0.84(0.78,0.90) | <0.001 | 0.84(0.78,0.90) | <0.001 |
| All-cause Mortality | ||||||
| 0%~50% | 1.62(1.29,2.03) | <0.001 | 1.59(1.26,2.00) | <0.001 | 1.59(1.26,2.00) | <0.001 |
| >50%~75% | 1.50(1.15,1.95) | 0.003 | 1.40(1.07,1.83) | 0.013 | 1.38(1.06,1.80) | 0.018 |
| >75%~100% | 1.00(Reference) | … | 1.00(Reference) | … | 1.00(Reference) | … |
| Per 1 SD | 0.81(0.75,0.89) | <0.001 | 0.82(0.75,0.90) | <0.001 | 0.82(0.75,0.90) | <0.001 |
[i] HR = hazard ratio.
Model 1: adjusted for age, gender, minority, randomization to rate vs. rhythm control strategies and history of smoking;
Model 2: further adjusted for past medical history of hypertension, diabetes mellitus, coronary artery disease and heart failure status by NYHA class symptoms;
Model 3: further adjusted for history of coronary artery bypass graft, interventional procedure and pacemaker implantation.
Figure 1
The associations of time in target range groups and cardiovascular outcomes.
Figure 2
Hazard ratio for cardiovascular outcomes in prespecified subgroups.
Table 3
Associations of Time in Target Range of Resting Heart Rate and Cardiovascular Outcomes With and Without Adjustment for Mean Resting Heart Rate and Resting Heart Rate SD.
| OUTCOME | FULLY ADJUSTED† | FULLY ADJUSTED PLUS MEAN RHR | FULLY ADJUSTED PLUS RHR SD | |||
|---|---|---|---|---|---|---|
| HR* (95% CI) | p VALUE | HR* (95% CI) | p VALUE | HR* (95% CI) | p VALUE | |
| Major adverse cardiovascular events | 0.84(0.78,0.90) | <0.001 | 0.92(0.80,1.05) | 0.216 | 0.83(0.77,0.90) | <0.001 |
| All-cause mortality | 0.82(0.75,0.90) | <0.001 | 0.92(0.78,1.09) | 0.348 | 0.82(0.75,0.90) | <0.001 |
[i] *HR per 1-SD increase in time in target range of resting heart rate.
†Fully adjusted for age, gender, minority, randomization to rate vs. rhythm control strategies, history of smoking, past medical history of hypertension, diabetes mellitus, coronary artery disease and heart failure status by NYHA class symptoms, coronary artery bypass graft, interventional procedure and pacemaker implantation.
Figure 3
Graphical abstract.
Time in target range of resting heart rate as a predictor of cardiovascular outcomes.