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. 2018 Nov 5;5(2):e000887.
doi: 10.1136/openhrt-2018-000887. eCollection 2018.

Nocturnal respiratory rate as a predictor of mortality in patients with acute coronary syndrome

Christian Eick  1 , Patrick Groga-Bada  1 , Kathrin Reinhardt  1 , Martin Duckheim  1 , Lars Mizera  1 , Katharina Böhm  1 , Nina Götz  1 , Meinrad Gawaz  1 , Christine Zürn  1
Affiliations

Nocturnal respiratory rate as a predictor of mortality in patients with acute coronary syndrome

Christian Eick et al. Open Heart. .

Abstract

Background: Patients with acute coronary syndrome (ACS) are at risk especially in the period shortly after the event. Alterations in respiratory control have been associated with adverse prognosis. The aim of our study was to assess if the nocturnal respiratory rate (NRR) is a predictor of mortality in patients with ACS presenting in the emergency department.

Methods: Clinically stable consecutive patients with ACS aged ≥ 18 years were prospectively enrolled. The Global Registry of Acute Coronary Events (GRACE) score and left ventricular ejection fraction (LVEF) were assessed for all patients. The average NRR over a period of 6 hours was determined by the records of the surveillance monitors in the first night after admission. Primary and secondary endpoints were intrahospital and 2 years all-cause mortality, respectively.

Results: Of the 860 patients with ACS, 21 (2.4%) died within the intrahospital phase and 108 patients (12.6%) died within the subsequent 2 years. The NRR was a significant predictor of both endpoints and was independent from the GRACE score and LVEF. Implementing the NRR into the GRACE risk model leads to a significant increase of the C-statistics especially for prediction of intrahospital mortality.

Conclusion: The NRR is an independent predictor of mortality in patients with ACS.

Keywords: mortality; myocardial infarction; respiration.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Receiver-operator characteristic curves for prediction of the primary and secondary endpoint by the nocturnal respiratory rate (NNR) in patients with acute coronary syndrome. AUC, area under the curve.
Figure 2
Figure 2
Cumulative mortality rate of patients stratified by the nocturnal respiratory rate (NNR) <16.8 breaths/min and ≥16.8 breaths/min, respectively.
Figure 3
Figure 3
Receiver-operator characteristic curves for prediction of the primary and secondary endpoint in patients with acute coronary syndrome. (A, B)The GRACE score as well as the combination of the GRACE score and the nocturnal respiratory rate (NRR). AUC, area under the curve.
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