Resting heart rate as an independent predictor of major adverse cardiovascular events in patients receiving maintenance hemodialysis: a prospective cohort study

作者：Ruoyu Tong, Liming Fan, Zhengmao Luo, Zijie Huang, Weidong Zhang, Meng Shen, Qiong Wu, Kairong Zheng, Xinwei Wang, Jin Li, Shuzhen Zhou, 黄远航, Xianyang Zhong · 发表于：Frontiers in Medicine · 年份：2026 · DOI：10.3389/fmed.2026.1850489 · 研究领域：Heart rate and cardiovascular health、Heart Failure Treatment and Management、Medication Adherence and Compliance

Background Existing clinical evidence in the literature regarding the association between resting heart rate (RHR) and major adverse cardiovascular events (MACE) in patients receiving maintenance hemodialysis (MHD) remains unclear and inconsistent. Objective To determine whether RHR independently predicts major adverse cardiovascular events (MACE) in patients receiving maintenance hemodialysis (MHD). Methods We conducted a prospective cohort study in which 309 adult MHD patients receiving maintenance hemodialysis were stratified into three groups according to the 33rd and 66th percentiles of baseline RHR. The primary outcome was incidence of MACE. Univariaable and multivariaable logistic regression analyses were performed, followed by internal validation of the final multivariable model using bootstrap resampling. A nomogram, calibration plots, and decision curve analysis (DCA) were used to evaluate model performance and clinical utility. It is noteworthy that heart failure events were identified based on the documented clinical diagnosis made by the treating physician after comprehensive assessment of symptoms, signs, medical history, and available investigations. Although BNP measurements and echocardiographic assessments were not available for all patients, their absence did not preclude a clinical diagnosis of heart failure in routine practice. Results The incidence of total MACE increased progressively across RHR tertiles (T1: 20.5%, T2: 38.0%, T3: 52.6%; p < 0.00...