Association between preoperative ambulatory heart rate and postoperative myocardial injury: a retrospective cohort study

British Journal of Anaesthesia
K S LadhaDuminda N Wijeysundera

Abstract

Resting heart rate is well established as a predictor of morbidity and mortality in the general population. However, the relationship between preoperative heart rate and perioperative outcomes, specifically myocardial injury, is unclear. This retrospective cohort study included patients undergoing elective major non-cardiac surgery from 2008 to 2014 at a multisite healthcare system. The exposure was ambulatory heart rate measured during the outpatient preoperative clinic visit, whereas the outcome of interest was myocardial injury (peak postoperative troponin I concentration >30 ng L-1). Covariates included patient characteristics, comorbidities, and preoperative medications. We constructed several multivariable regression models that each modelled heart rate in a different manner, including as a simple continuous variable, categories, and fractional polynomials. The cohort included 41 140 patients, of whom 4857 (11.8%) experienced myocardial injury. Based on pre-specified heart categories thresholds, a heart rate ≥90 beats min-1 was associated with an elevated odds of myocardial injury compared with a heart rate <60 beats min-1 (adjusted odds ratio, 1.22; 95% confidence interval, 1.06-1.39; P=0.005). This result was consistent...Continue Reading

Citations

Jan 10, 2019·European Journal of Anaesthesiology·Bernardo Bollen PintoGareth Ackland
Feb 17, 2021·The British Journal of Oral & Maxillofacial Surgery·B B LalabekyanR C M Stephens
Jul 6, 2021·Journal of the American Heart Association·Corien S A WeersinkWilton A van Klei

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