Table_1_Prognostic Potential of Heart Rate and Hypertension in Multiple Myeloma Patients.docx

Background: The prognosis of patients with multiple myeloma (MM) is variable and partly depends on their cardiovascular status. The presence of arrhythmias can lead to worse outcomes. Therefore, this study aimed to evaluate the potential of heart rate (HR) and hypertension in predicating the outcomes of MM patients.
Methods: This study retrospectively enrolled patients with MM between January 1, 2010, and December 31, 2018, at the First Affiliated Hospital of Xi'an Jiaotong University. The endpoint was all-cause mortality. The Pearson's chi-square test was used to assess the association between hypertension and outcomes. Univariate and multivariate Cox proportional hazards models were developed to evaluate the relationship between HR and all-cause mortality.
Results: A total of 386 patients were included. The mean HR was 83.8 ± 23.1 beats per minute (bpm). Patients with HR >100 bpm had a higher all-cause mortality (79.4%, 50/63) than those with 60 ≤ HR ≤ 100 bpm (39.9%, 110/276) and <60 bpm (19.1%, 9/47) (p < 0.001). Subgroup analysis based on the International Staging System and sex revealed similar relationships (p < 0.01). When stratified by age, patients with HR >100 bpm had higher all-cause mortality than those with a lower HR when age was <65 years or 65–75 years (p < 0.001) but not >75 years. The proportion of patients with hypertension was 54.7% (211/386). However, hypertension was not associated with all-cause mortality in MM patients (χ2=1.729, p > 0.05). MM patients with HR >100 bpm had the highest all-cause mortality.
Conclusions: The prognostic potential of HR may be useful in aiding risk stratification and promoting the management of these patients.

背景：多发性骨髓瘤（multiple myeloma, MM）患者的预后存在显著异质性，且在一定程度上与其心血管状态相关。心律失常可导致不良临床结局，因此本研究旨在评估心率（heart rate, HR）与高血压对MM患者预后的预测价值。
方法：本研究回顾性纳入2010年1月1日至2018年12月31日期间于西安交通大学第一附属医院收治的MM患者。本研究的主要终点为全因死亡率。采用Pearson卡方检验（Pearson's chi-square test）评估高血压与患者预后的相关性；构建单因素及多因素Cox比例风险模型（Cox proportional hazards models），以分析HR与全因死亡率之间的关联。
结果：本研究共纳入386例MM患者，其平均HR为83.8±23.1次/分（beats per minute, bpm）。HR＞100 bpm的患者全因死亡率为79.4%（50/63），显著高于HR处于60≤HR≤100 bpm区间的患者（39.9%，110/276）及HR＜60 bpm的患者（19.1%，9/47）（p＜0.001）。基于国际分期系统（International Staging System）与性别进行的亚组分析显示，二者的相关性保持一致（p＜0.01）。按年龄分层后，在年龄＜65岁或65~75岁的亚组中，HR＞100 bpm的患者全因死亡率显著高于HR更低的患者（p＜0.001），但在年龄＞75岁的亚组中未观察到该差异。本研究中高血压患者占比为54.7%（211/386），然而高血压与MM患者的全因死亡率并无显著关联（χ²=1.729，p＞0.05）。HR＞100 bpm的MM患者全因死亡率最高。
结论：HR的预后预测价值或可辅助MM患者的临床风险分层，并为此类患者的管理提供参考依据。