Correlation of Admission Heart Rate With Angiographic and Clinical Outcomes in Patients With Right Coronary Artery ST‐Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: HORIZONS‐AMI (The Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) Trial

BackgroundBradycardia on presentation is frequently observed in patients with right coronary artery ST‐segment elevation myocardial infarction, but it is largely unknown whether it predicts poor angiographic or clinical outcomes in that patient population. We sought to determine the prognostic implications of admission heart rate (AHR) in patients with ST‐segment elevation myocardial infarction and a right coronary artery culprit lesion. Methods and ResultsWe analyzed 1460 patients with ST‐segment elevation myocardial infarction and a right coronary artery culprit lesion enrolled in the randomized HORIZONS‐AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial who underwent primary percutaneous coronary intervention. Patients presenting with high‐grade atrioventricular block were excluded. Outcomes were examined according to AHR range (AHR 100 beats per minute). Angiographic analysis showed no significant association between AHR and lesion location or complexity. On multivariate analysis, admission bradycardia (AHR