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Studies in general population, in elderly people, and in groups of patients with arterial hypertension, myocardial infarction, stable coronary heart disease, diabetes mellitus, and after coronary bypass surgery have shown that elevated heart rate (HR) is prognostically unfavorable factor of cardiovascular and total mortality independent of other risk factors. Moreover, it has been shown that tachycardia to a certain extent correlates with severity and progression of atherosclerosis and can promote damage of integrity of atherosclerotic plaque. Plaque rupture plays main role in pathogenesis of acute coronary syndrome (ACS). Lowering of HR is one of therapeutic approaches to prevention of plaque rupture, i.e. to lowering of risk of ACS development. Mechanisms of interrelationships between HR and ACS and possibilities to influence HR with drugs in ACS are presented in this review.
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