CAD patients: heart rate and prognosis

Increased heart rate (HR) is associated with cardiovascular events (CVE) in the general population, in those with cardiovascular risk factors, and in patients with coronary artery disease (CAD). Further, it is well-known that in patients with heart failure (HF), low HR is linked with significantly lower rates of CVE.
β-blockers (BBs) have been shown to strongly reduce CVE rates in HF patients with reduced left ventricular ejection fraction (HFrEF). However, the optimal HR and BB dose in patients with CAD remain unclear.
This study by Oba Y, Kabutoya T, Kohro T, et al. thus aims to establish clear relationships between HR, BB dose, and prognosis in patients with CAD.

Key learnings

HR≥75 beats/min was significantly associated with major adverse cardiac and cerebral events (MACCE) in patients with CAD. Further, patients with acute coronary syndrome administered with a low dose of BB had a significantly higher incidence of MACCE than those treated with a standard dose. This finding confirms the well-known benefit of administering BBs in doses greater than the standard dose for patients with HFrEF. However, no association was found between BB dose and incidence of MACCE in patients with chronic coronary syndrome.