Cardiometabolic & kidneySecondary analysis
Resting heart rate and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk analysis from the ONTARGET/TRANSCEND trials
- Secondary analysis of the ONTARGET/TRANSCEND randomised trials
- 733 centres in 40 countries
Results robust after adjusting for risk indicators including beta-blocker use and AF
Authors' conclusion
Mean RHR above 75-80 b.p.m. was associated with increased risk for cardiovascular outcomes except for stroke.
Study context
- Population
- Patients aged ≥55 years with a history of or at high risk for CVD (after MI, stroke or with proven peripheral vascular disease), with or without diabetes11,487 with diabetes
- Participants
- 30,937 patients
- Comparison
- Mean achieved on-treatment resting heart rate (RHR) categories, in patients with vs without diabetes
- Primary endpoint
- Composite of:
- CV death
- MI
- Stroke
- Hospitalization for HF
- Follow-up
- Median 56 months
Primary result
As reported in the abstract
Primary composite outcome by mean RHR
Each group vs 60 ≤ 65 bpmEstimate (CI)
75 ≤ 80 bpmno diabetes
adjusted HR 1.17(1.01–1.36)
≥80 bpmdiabetes
HR 1.96(1.64–2.34)
≥80 bpmno diabetes
HR 1.73(1.49–2.00)
Further findings
| Outcome | Values | HR (CI) | P value | |
|---|---|---|---|---|
| CV death by mean RHR — ≥80 bpm vs 60 ≤ 65 bpm · diabetes | 1.99 (1.53–2.58) | |||
| CV death by mean RHR — ≥80 bpm vs 60 ≤ 65 bpm · no diabetes | 1.73 (1.38–2.16) | |||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| RHR, diabetes vs no diabetes | Diabetes 71.8 ± 9.0 · No diabetes 67.9 ± 8.8 | P < 0.0001 |
Hospitalization for HF, all-cause death, MI, stroke
- Similar results for hospitalization for HF and all-cause death; effect of RHR on MI and stroke less pronounced
Original publication
Resting heart rate and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk analysis from the ONTARGET/TRANSCEND trials. Eur Heart J. Published 24 December 2018. doi:10.1093/eurheartj/ehy808
Summarised from the published abstract; every number is checked against it