Heart rate management in coronary artery disease: the CLARIFY registry

Coronary artery disease (CAD) is and will remain the first cause of death worldwide. With progress made in treatment, an increasing number of patients survive acute coronary syndromes and will live as outpatients with or without anginal symptoms. The characteristics, management, and outcomes of patients with chronic stable CAD are not well known, because most of the information available stems from the highly selected patient populations enrolled in randomized clinical trials or from hospital-based cohorts and was gathered almost exclusively in Europe and North America. Finally, a large fraction of the information available relates to patients with anginal symptoms. To better characterize these patients, a large international observational registry will be launched: CLARIFY aims to enrol in more than 30 countries over four continents similar to 25 000 outpatients with stable CAD, defined as history of documented myocardial infarction (of more than 3 months), prior coronary revascularization, chest pain with documented myocardial ischaemia or coronary stenosis of >50% proven by angiography. Patients will be followed up annually to 5 years, with collection of information regarding risk factors, medical history, anthropometric indices, blood pressure, and heart rate, laboratory measurements, treatments and cardiovascular events and procedures. Establishing the determinants of prognosis and particularly the impact of resting heart rate is among the main goals. CLARIFY will provide contemporary information regarding characteristics management and outcomes of patients with stable CAD. This should help improve care and ultimately the outcomes of these patients.