Obstructive Lung Diseases: COPD |

Resting Heart Rate Following Acute Exacerbation of COPD Predicts Future Exacerbation FREE TO VIEW

Aisya Musa; Mohd Mohd Zim; Mohd Fadzil; Norhaya Mohd Razali; Jyi Lin Wong; Razul Md Nazri Md Kassim; Tengku Ismail; Mohammed Fauzi Abdul Rani; Ahmad Ismail
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UITM, Shah Alam, Malaysia

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A346. doi:10.1016/j.chest.2016.02.361
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SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 09:45 AM - 11:15 AM

PURPOSE: Resting heart is a readily available clinical data and has been shown to predict mortality in COPD patients (Jensen, Marott et al. 2013). Yet, the association between heart rate and exacerbation is lacking. We aim to see the effect of resting heart rate on future COPD exacerbations.

METHODS: A total of 226 subjects (8 centres) were recruited following an acute exacerbation (AE) of COPD requiring hospitalisation. Their baseline demographics data and resting heart rate (baseline HR) at 3 months after an acute exacerbation were recorded. Patient’s exacerbation histories were recorded at 6, 9, 12 and 15 months after an AE. Patients who are on beta blockers, rate modifying drugs or have a history of congestive cardiac failure were excluded. Statistical analysis was done to compare between the exacerbator group (group 1) and the non-exacerbator group (group 2).

RESULTS: The mean age is 66.9±10.3 years old. There is no significant difference in baseline demographics data or medications between the 2 groups. The mean baseline HR is 89.02±15.64 beats per minute (bpm). At 6 months, 33.3% exacerbate. There is a significant correlation between baseline HR and exacerbation frequency (r=0.31, p=0.002). The mean baseline HR is significantly higher in group 1 (91.37±8.66 vs 85.69±11.00, p=0.004). There is a significantly higher proportion of exacerbators in those with HR >80 bpm vs HR <80 bpm (55.4% vs 20.8%, p=0.003) with a relative risk (RR) of 1.78 (95% CI 1.31-2.41). At 9 months, 69.7% exacerbate. There is a significant correlation between baseline HR and exacerbation frequency (r=0.42, p=0.001). The mean baseline HR is significantly higher in group 1 (90.50±9.82 vs. 85.00±10.53, p=0.045). There is also a significantly higher proportion of exacerbators in those with HR > 80 bpm (75.9% Vs 46.2%, p=0.035) with a RR of 2.23 (CI 1.12-4.46). At 12 months onwards, although the trend of mean resting HR is higher in group 1, there is no significant difference between the 2 groups. The correlation between resting HR and exacerbation frequency is significant at 12 months only (r= 0.396, p=0.008).

CONCLUSIONS: Baseline resting HR may predict future risk of COPD exacerbations up to 9 months after an AE requiring hospitalisation. The higher the HR, the higher the frequency of exacerbation. Patients with baseline HR of >80 bpm is at higher risk of developing an exacerbation.

CLINICAL IMPLICATIONS: Further larger study is needed to assess this relationship and whether reduction in heart rate will result in reduce frequency of exacerbation.

DISCLOSURE: The following authors have nothing to disclose: Aisya Musa, Mohd Mohd Zim, Mohd Fadzil, Norhaya Mohd Razali, Jyi Lin Wong, Razul Md Nazri Md Kassim, Tengku Ismail, mohammed fauzi Abdul Rani, Ahmad Ismail

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