In 421 AHFS patients, we analyzed the relationship between HRR during hospitalization and the prognosis after discharge. During a mean follow-up period of 1.9 years, 76 and 55 patients died or were re-hospitalized for HF, respectively. Although HR at discharge did not influence cardiac events (hazard ratio [HR]: 1.00 [95 % CI; 0.99-1.02], p = 0.22), the extent of HRR was a predictor of cardiac events (HR: 0.89 [0.84-0.96], p < 0.001). Kaplan-Meier analysis revealed that the cardiac event rate of the HRR-positive group (¡Ý27 bpm reduction of HR from 114 ¡À 24 at admission to 65 ¡À 11 bpm at discharge) was significantly lower than that of the HRR-negative group (¡Ü26 bpm (=median value) reduction of HR from 74 ¡À 14 to 71 ¡À 14 bpm). In the HRR-positive group, the cardiac event rate was significantly lower in patients receiving beta-blockers. Furthermore, the extent of HR change was an important predictor of cardiac events among other markers, compared with the change in systolic blood pressure or B-type natriuretic peptide.
The HR itself at discharge was not associated with the prognosis, but the extent of HRR achieved by treatment of HF with beta-blockers was a strong predictor for the clinical outcome in AHFS patients.