{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:16:57Z","timestamp":1793258217682,"version":"4.5.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008990","name":"Science and Technology Department of Zhejiang Province","doi-asserted-by":"publisher","award":["NO.LLSSY24H020003"],"award-info":[{"award-number":["NO.LLSSY24H020003"]}],"id":[{"id":"10.13039\/501100008990","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008990","name":"Science and Technology Department of Zhejiang Province","doi-asserted-by":"publisher","award":["NO.LLSSY24H020003"],"award-info":[{"award-number":["NO.LLSSY24H020003"]}],"id":[{"id":"10.13039\/501100008990","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008990","name":"Science and Technology Department of Zhejiang Province","doi-asserted-by":"publisher","award":["NO.LLSSY24H020003"],"award-info":[{"award-number":["NO.LLSSY24H020003"]}],"id":[{"id":"10.13039\/501100008990","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To quantify the shape and strength of the association between heart rate (HR) recorded during the first 30\u00a0min of intensive-care admission and in-hospital death in contemporary acute myocardial infarction (AMI), after adjustment for modern reperfusion, pharmacotherapy, and haemodynamic variables.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We extracted 1,510 adults with a primary International Classification of Diseases, Ninth Revision (ICD-9) diagnosis of AMI (410.xx) from MIMIC-III (2008\u20132012). HR was defined as the mean of the first three electrocardiographic readings obtained within 30\u00a0min of ICU triage, before administration of rate-modifying drugs. We modelled HR both as clinically meaningful categories (&lt;\u200960, 60\u201399, \u2265\u2009100\u00a0bpm) and as a continuous exposure using restricted cubic splines (RCS). Multivariable logistic regression adjusted for age, sex, Killip class, systolic blood pressure, coronary revascularisation, \u03b2-blocker use, atrial fibrillation\/flutter, hypertension, diabetes, chronic obstructive pulmonary disease, serum creatinine, haemoglobin, white blood cell count, sodium, potassium, glucose, platelet count and anion gap. Pre-specified subgroup analyses compared ST-elevation MI (STEMI) with non-ST-elevation ACS (NSTE-ACS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Mean age was 66.7\u2009\u00b1\u200913.9 years; 33.6% were women; STEMI accounted for 42%. Overall in-hospital mortality was 10.9%. HR\u2009\u2265\u2009100\u00a0bpm (23% of patients) was associated with higher death risk (adjusted OR 2.45, 95% CI 1.56\u20133.85) versus 60\u201399\u00a0bpm. Bradycardia\u2009&lt;\u200960\u00a0bpm (15%) was also associated with excess risk (adjusted OR 1.58, 95% CI 1.02\u20132.45), yielding a U-shaped RCS curve (non-linearity <jats:italic>p<\/jats:italic>\u2009=\u20090.01). The HR\u2013mortality gradient was steeper in STEMI than in NSTE-ACS (interaction <jats:italic>p<\/jats:italic>\u2009=\u20090.04). Findings were robust after including the 46 patients who died within 24\u00a0h of admission.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Admission HR exhibits a U-shaped, independent relation with early mortality in modern AMI care; values outside 60\u201399\u00a0bpm identify high-risk patients despite urgent reperfusion and optimal medical therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12872-025-04957-5","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T09:51:01Z","timestamp":1751622661000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Admission heart rate and in-hospital mortality in acute myocardial infarction: a contemporary analysis of the MIMIC-III cohort"],"prefix":"10.1186","volume":"25","author":[{"given":"Weidong","family":"Lan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bitong","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sailing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"issue":"3","key":"4957_CR1","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/0735-1097(92)90033-J","volume":"20","author":"RM Jacoby","year":"1992","unstructured":"Jacoby RM, Nesto RW. Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis. J Am Coll Cardiol. 1992;20(3):736\u201344.","journal-title":"J Am Coll Cardiol"},{"key":"4957_CR2","first-page":"109","volume":"5","author":"XX Qi","year":"2020","unstructured":"Qi XX, et al. Analysis of risk factors of death in patients with acute myocardial infarction during hospitalization. China Med Records. 2020;5:109\u201312.","journal-title":"China Med Records"},{"issue":"2","key":"4957_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jjcc.2019.02.007","volume":"74","author":"SN Lee","year":"2019","unstructured":"Lee SN, Moon D, Moon KW, et al. The Glasgow prognostic score as a significant predictor of clinical outcomes in patients with acute coronary syndrome. J Cardiol. 2019;74(2):130\u20135.","journal-title":"J Cardiol"},{"issue":"2","key":"4957_CR4","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1177\/2048872616672077","volume":"7","author":"MT Jensen","year":"2018","unstructured":"Jensen MT, Pereira M, Araujo C, et al. Heart rate at admission is a predictor of in-hospital mortality in patients with acute coronary syndromes: results from 58 European hospitals. Eur Heart J Acute Cardiovasc Care. 2018;7(2):149\u201357.","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"issue":"4","key":"4957_CR5","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3109\/17482941.2011.628028","volume":"13","author":"AT Tim\u00f3teo","year":"2011","unstructured":"Tim\u00f3teo AT, Toste A, Ramos R, Oliveira JA, Ferreira ML, Ferreira RC. Admission heart rate as a predictor of mortality in patients with acute coronary syndromes. 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Am J Cardiol. 2015;116(8):1157\u201362.","journal-title":"Am J Cardiol"},{"issue":"9","key":"4957_CR10","doi-asserted-by":"publisher","first-page":"e371","DOI":"10.1161\/CIRCULATIONAHA.113.005631","volume":"129","author":"LS Maier","year":"2014","unstructured":"Maier LS, Maier SK, Scholz KH. Letter by Maier et al regarding article, emergency department bypass for ST-segment-elevation myocardial infarction patients identified with a prehospital electrocardiogram: a report from the American Heart Association mission: lifeline program. Circulation. 2014;129(9):e371.","journal-title":"Circulation"},{"key":"4957_CR11","first-page":"594","volume":"7","author":"CM Wang","year":"2008","unstructured":"Wang CM, et al. Effect of heart rate on in-hospital mortality of patients with acute myocardial infarction. 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The study adhered to the Declaration of Helsinki. The study was approved by the Ethics Committee of Lishui Municipal Central Hospital and the Fifth Affiliated Hospital of Wenzhou Medical University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"484"}}