Aims: Both elevated inflammatory activity and sustained tachycardia reflect unfavourable cardiovascular risk profiles, and
there is evidence to suggest the deleterious effects of inflammation are amplified by increased heart rate. The purpose of
this study was to assess the interaction between resting heart rate and inflammation in cardiovascular mortality.
and results: A total of 3267 patients (2283 men), aged 18-95 years, scheduled for coronary angiography, were followed prospectively.
By principle component analysis, we developed an overall multi-marker index of inflammation weighting the respective coefficients
of five inflammatory markers including: interleukin-6, C-reactive protein, serum amyloid A, neutrophils, and fibrinogen. Cox
proportional hazard regression models were employed to evaluate the relationship between inflammation and heart rate with
cardiovascular mortality. Across 29 940 person years of follow-up, there were 546 (17%) deaths due to cardiovascular disease
(CVD). Significantly, we observed a strong synergistic effect of inflammatory activity and concurrent elevated heart rate.
For CVD mortality, patients in the highest quartile of inflammation had an adjusted hazard ratio (95% confidence interval)
of 1.84 (1.31-2.57), P < 0.0001 if their resting heart rate was <75 b.p.m. Substantially, patients had a greater adjusted
HR of 7.50 (3.21-17.50), P < 0.0001 if their resting heart rate was ≥75 b.p.m.
Conclusion: The present analyses
underline elevated inflammation as a risk factor for cardiovascular mortality. The effects of inflammation appeared to be
strongly amplified by a faster resting heart rate. If confirmed by additional studies, this association may prove a useful
adjunct for therapeutic approaches to alleviate symptoms and prolong survival.