• Am. J. Crit. Care · Sep 2022

    No Association of Early Postoperative Heart Rate With Outcomes After Coronary Artery Bypass Grafting.

    • Yoshihisa Morita, Junji Kumasawa, Yoshihisa Miyamoto, Junichi Izawa, Vijay Krishnamoorthy, Karthik Raghunathan, Raquel R Bartz, Annemarie Thompson, and Tetsu Ohnuma.
    • Yoshihisa Morita is an assistant professor, Department of Anesthesiology, University of Maryland Medical Center, Baltimore, Maryland.
    • Am. J. Crit. Care. 2022 Sep 1; 31 (5): 402410402-410.

    BackgroundElevated perioperative heart rate potentially causes perioperative myocardial injury because of imbalance in oxygen supply and demand. However, large multicenter studies evaluating early postoperative heart rate and major adverse cardiac and cerebrovascular events (MACCEs) are lacking.ObjectiveTo assess the associations of 4 postoperative heart rate assessment methods with in-hospital MACCEs after elective coronary artery bypass grafting (CABG).MethodsUsing data from the eICU Collaborative Research Database in the United States from 2014 to 2015, the study evaluated postoperative heart rate measured during hospitalization within 24 hours after intensive care unit admission. Four heart rate assessment methods were evaluated: maximum heart rate, duration above heart rate 100/min, area above heart rate 100/min, and time-weighted average heart rate. The outcome was in-hospital MACCEs, defined as a composite of in-hospital death, myocardial infarction, angina, arrhythmia, heart failure, stroke, cardiac arrest, or repeat revascularization.ResultsAmong 2585 patients, the crude rate of in-hospital MACCEs was 6.2%. In multivariable logistic regression analysis, the adjusted odds ratios (95% CI) for in-hospital MAC-CEs assessed by maximum heart rate in each heart rate category (beats per minute: >100-110, >110-120, >120-130, and >130) were 1.43 (0.95-2.15), 0.98 (0.56-1.64), 1.47 (0.76-2.69), and 1.71 (0.80-3.35), respectively. Similarly, none of the other 3 methods were associated with MACCEs.ConclusionsMore research is needed to assess the usefulness of heart rate measurement in patients after CABG.©2022 American Association of Critical-Care Nurses.

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