We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate < 70 bpm (n = 8178) or ¡Ý 70 bpm (n = 10 802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored.
Heart rate ¡Ý 70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95 % CI 1.03-1.69, P = 0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3 % , P = 0.0002). Heart rate ¡Ý 70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P < 0001); vascular death (P < 0001); all-cause mortality (P < 0001); and fatal or nonfatal stroke (P = 0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7 % , P < 0.0001), vascular death (11.0 % , P < 0.0001), all-cause mortality (8.0 % , P < 0.0001), and fatal and nonfatal stroke (2.4 % , P = 0.057).
Elevated heart rate ¡Ý 70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI.