Impact of Anemia on In-Hospital, One-Month and One-Year Mortality in Patients with Acute Coronary Syndrome from the Middle East

Sulaiman, Kadhim; Panduranga, Prashanth; Al‐Zakwani, Ibrahim; Almahmeed, Wael; Al-Motarreb, Ahmed; Suwaidi, Jassim Al; Amin, Haitham; Asaad, Nidal; Hersi, Ahmad; Faleh, Hussam Al; Saif, Shukri Al; Alsheikh‐Ali, Alawi A.; Lawati, Jawad Al; Alhabib, Khalid F

doi:10.3121/cmr.2011.1032

Cited by 18 publications

(16 citation statements)

References 29 publications

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“…In patients with coronary artery disease, the prevalence of anemia on admission varied widely across previous studies and ranged from 11% [ 10 ] to up to 38% [ 11 ]. Compared to most previous studies, the prevalence of anemia in our population (14.1%) was low [ 1 , 8 , 10 , 11 , 16 – 21 ]. Those studies focused either only on patients with STEMI or included all patients with acute coronary syndrome (ACS), which might explain the disparities.…”

Section: Discussioncontrasting

confidence: 91%

“…They were less often treated with PCI, but more frequently with CABG, which might be an indicator of more advanced coronary artery disease. In line, previous studies demonstrated that anemic patients were less often treated with PCI [ 18 , 21 ] and experienced worse outcomes after PCI, e.g. increased risks for stent thrombosis, long-term mortality, MACE and bleeding [ 3 , 4 , 23 , 31 ].…”

Section: Discussionsupporting

confidence: 76%

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Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Colombo

Kirchberger

Amann

et al. 2018

BMC Cardiovasc Disord

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BackgroundPrevious studies have shown that the presence of anemia is associated with increased short- and long-term outcomes in patients with acute myocardial infarction (AMI). This study aims at examining the impact of admission anemia on long-term, all-cause mortality following AMI in patients recruited from a population-based registry. Contrary to most prior studies, we distinguished between patients with mild and moderate to severe anemia.MethodsThis prospective study was conducted in 2011 patients consecutively hospitalized for AMI that occurred between January 2005 and December 2008. Patients who survived more than 28 days after AMI were followed up until December 2011. Hemoglobin (Hb) concentration was measured at hospital admission and classified according to the World Health Organization (WHO). Mild anemia was defined as Hb concentration of 11 to < 12 g/dL in women and 11 to < 13 g/dL in men; moderate to severe anemia as Hb concentration of < 11 g/dL. Adjusted Cox regression models were calculated to compare survival in patients with and without anemia.ResultsMild anemia and moderate to severe anemia was found in 183 (9.1%) and 100 (5%) patients, respectively. All-cause mortality after a median follow-up time of 4.2 years was 11.9%. The Cox regression analysis showed significantly increased mortality risks in both patients with mild (HR 1.74, 95% CI 1.23–2.45) and moderate to severe anemia (HR 2.05, 95% CI 1.37–3.05) compared to patients without anemia.ConclusionThis study shows that anemia adversely affects long-term survival following AMI. However, further studies are needed to confirm that anemia can solely explain worse long-term outcomes after AMI.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0785-5) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionsupporting

confidence: 76%

Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Colombo

Kirchberger

Amann

et al. 2018

BMC Cardiovasc Disord

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“…ACS: acute coronary syndrome; aHR: adjusted HR; aOR: adjusted odds ratio; CABG: coronary artery bypass graft; CI: confidence interval; HR: hazard ratio; OR: odds ratio; PCI: percutaneous coronary intervention; RR: relative risk.This table reports data from two meta-analyses [9,14] and six observational studies [15-20] that were not included in these meta-analyses. a Overall, the meta analysis conducted by Liu et al . [14] included 241,293 patients enrolled in 19 studies; the analysis on mortality (10 studies) disclosed a very important heterogeneity ( I 2 = 84%).…”

Section: Reviewmentioning

confidence: 99%

Anemia and red blood cell transfusion in critically ill cardiac patients

Pont‐Thibodeau

Harrington

Lacroix

2014

Ann. Intensive Care

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Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transfused cardiac patients. Both anemia and RBC transfusion are common in cardiac patients, and both are associated with mortality. RBC transfusion is the only way to rapidly treat severe anemia, but is not completely safe. In addition to hemoglobin (Hb) concentration, the determinant(s) that should drive a practitioner to prescribe a RBC transfusion to cardiac patients are currently unclear. In stable acyanotic cardiac patients, Hb level above 70 g/L in children and above 70 to 80 g/L in adults appears safe. In cyanotic children, Hb level above 90 g/L appears safe. The appropriate threshold Hb level for unstable cardiac patients and for children younger than 28 days is unknown. The optimal transfusion strategy in cardiac patients is not well characterized. The threshold at which the risk of anemia outweighs the risk of transfusion is not known. More studies are needed to determine when RBC transfusion is indicated in hospitalized patients with cardiac disease.

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“…In several studies regarding hemoglobin and mortality, anemia and polycythemia have been demonstrated to be associated with increased mortality, where hemoglobin levels and all-cause mortality are known to form a U-shape relationship 1,2 . In particular, anemia increases the risk of hospitalization and death in the elderly 3 and is considered as a risk factor for myocardial infarction, heart failure, sepsis, and chronic renal failure 4–7 . In addition, anemia is a common complication in patients with chronic renal failure and hematopoietic agents such as erythropoietin-stimulating agents (ESAs) are frequently used for treatment.…”

Section: Introductionmentioning

confidence: 99%

Association between long-term hemoglobin variability and mortality in Korean adults: a nationwide population-based cohort study

Son

Yang

2019

Sci Rep

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Hemoglobin variability is known to be associated with mortality in patients with chronic renal failure and cardiovascular disease. However, the effect of hemoglobin variability on mortality in the general population has not yet been studied. We aimed to investigate the association between hemoglobin variability and mortality using Korean cohort from National Health Insurance Service-Health Screening 2002–2015 database. This study was conducted on 182,757 adults who underwent more than 4 health screenings from 2002 to 2009. Hemoglobin variability was assessed by 3 indices of coefficient of variation (CV), standard deviation (SD), and variability independent of the mean (VIM). Cox proportional hazard regression analysis was performed for each index of quartile groups (Q1–Q4). The hazard ratio and 95% confidence interval^l for all-cause mortality comparing Q2, Q3 and Q4 with Q1 of hemoglobin variability CV in the multivariable adjusted model were 1.07 [0.96–1.20], 1.18 [1.06–1.31] and 1.43 [1.29–1.58] respectively. As the 5% CV, SD, and VIM increased, the hazard ratio for mortality increased by 1.08 [1.06–1.10] in the multivariable adjusted model. Hemoglobin variability is not only important predictor in patients with chronic renal failure and cardiovascular disease but could also be considered as a useful predictor of mortality in the general population.

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Impact of Anemia on In-Hospital, One-Month and One-Year Mortality in Patients with Acute Coronary Syndrome from the Middle East

Cited by 18 publications

References 29 publications

Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Anemia and red blood cell transfusion in critically ill cardiac patients

Association between long-term hemoglobin variability and mortality in Korean adults: a nationwide population-based cohort study

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