Impact of Anemia and Acquired Anemia on in-Hospital Mortality of Acute Coronary Syndrome Patients

Objective: To investigate the associations of anemia-related parameters, with in-hospital mortality after acute coronary syndrome (ACS), as well as factors associated with prior anemia (PA) and hospital-acquired anemia (HAA) in patients with ACS. Methods: This was a retrospective cohort study conducted between June 2021 and May 2023. The data of patients diagnosed with ACS who were hospitalized and treated in our hospital were recorded, including age and sex, smoking and comorbidity status, laboratory findings, CHA2DS2-VASc scores, prior medication use, left ventricular ejection fraction, ACS type, the synergy between percutaneous intervention with taxus drug-eluting stents and cardiac surgery (SYNTAX) scores, stent thrombosis status and mortality status. Mortality was assessed according to in-hospital death. Patients were grouped based on anemia presence (PA and HAA). Results: A total of 329 patients were included in the study. Of these, 219 (66.56%) were in the no anemia group, 58 (17.63%) in the PA group, and 52 (15.81%) in the HAA group. The mean age of all participants was 61.27 +/- 12.45 years and 76.29% of them were male. 14 (4.26%) patients died during hospitalization. Multivariable logistic regression analysis had revealed that, prior coronary artery disease (OR: 3.779, 95% CI: 1.141-12.508, p=0.030), PA (OR: 7.043, 95% CI: 1.574-31.517, p = 0.011), HAA (OR: 5.857, 95% CI: 1.260-27.236, p=0.024) and high WBC (OR: 1.190, 95% CI: 1.028-1.378, p=0.020) were independently associated with the increased risk of in-hospital mortality. Conclusion: Consequently, the risk of in-hospital mortality is higher in patients with a previous history of coronary artery disease, PA, HAA and high WBC, and additional precautions should be taken in these patients.