Influence of Hemoglobin Level on In-Hospital Prognosis in Patients With Acute Coronary Syndrome

被引:26
作者
Gonzalez-Ferrer, Juan Jose [1 ]
Garcia-Rubira, Juan Carlos [1 ]
Balcones, David Vivas [1 ]
Gil, Ivan Nunez [1 ]
Barrio, Rocio Carda [1 ]
Fuentes-Ferrer, Manuel [2 ]
Fernandez-Ortiz, Antonio [1 ]
Macaya, Carlos [1 ]
机构
[1] Hosp Clin San Carlos, Inst Cardiovasc, Madrid 28040, Spain
[2] Hosp Clin San Carlos, Serv Med Prevent, Unidad Apoyo Invest, Madrid 28040, Spain
来源
REVISTA ESPANOLA DE CARDIOLOGIA | 2008年 / 61卷 / 09期
关键词
Prognosis; Acute coronary syndrome; Anemia; Myocardial infarction;
D O I
10.1016/S1885-5857(08)60255-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction and objectives. Many patients with acute coronary syndrome (ACS) suffer from anemia. The objective of this study was to determine the influence of the admission hemoglobin level and the post-admission fall in hemoglobin level on short-term prognosis during hospitalization. Methods. This retrospective study involved 542 high-risk ACS patients who were admitted during 2005. The hemoglobin level was recorded on admission and at least every 24 hours thereafter, with anemia being defined according to WHO criteria. Logistic regression modeling was used to assess the relationship of the admission hemoglobin level and the fall in hemoglobin level to all-cause mortality and cardiogenic shock during hospitalization. Results. During follow-up (median time, 7 days), the incidence of cardiogenic shock or mortality was 6.9% (37 patients). Anemia was present in 147 patients (27.1%) at admission, increasing to 266 patients (49.1%) during hospitalization (P<.0001). After adjusting for a range of variables, independent associations were found between the occurrence of adverse events and both the admission hemoglobin level (odds ratio [OR]=1.4 for each 1 g/dL below normal; 95% confidence interval [Cl], 1.1-1.8; P=.003) and a fall in hemoglobin level >1.8 g/dL (OR=5.4; 95% Cl, 1.5-18.8; P=.009). Conclusions. In high-risk ACS patients both the admission hemoglobin level and a subsequent fall in hemoglobin level >1.8 g/dL were associated with an increased risk of all-cause mortality or cardiogenic shock.
引用
收藏
页码:945 / 952
页数:8
相关论文
共 27 条
[1]   Effect of anemia on 1-year mortality in patients with acute myocardial infarction [J].
Al Falluji, N ;
Lawrence-Nelson, J ;
Kostis, JB ;
Lacy, CR ;
Ranjan, R ;
Wilson, AC .
AMERICAN HEART JOURNAL, 2002, 144 (04) :636-641
[2]   Hemoglobin level is an independent predictor for adverse cardiovascular outcomes in women undergoing evaluation for chest pain - Results from the national heart, lung, and blood institute women's ischemia syndrome evaluation study [J].
Arant, CB ;
Wessel, TR ;
Olson, MB ;
Merz, CNB ;
Sopko, G ;
Rogers, WJ ;
Sharaf, BL ;
Reis, SE ;
Smith, KM ;
Johnson, BD ;
Handberg, E ;
Mankad, S ;
Pepine, CJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (11) :2009-2014
[3]   Changes in haemoglobin levels during hospital course and long-term outcome after acute myocardial infarction [J].
Aronson, Doron ;
Suleiman, Mahmoud ;
Agmon, Yoram ;
Suleiman, Abeer ;
Blich, Miry ;
Kapeliovich, Michael ;
Beyar, Rafael ;
Markiewicz, Walter ;
Hammerman, Haim .
EUROPEAN HEART JOURNAL, 2007, 28 (11) :1289-1296
[4]   Incidence and predictors of bleeding after contemporary thrombolytic therapy for myocardial infarction [J].
Berkowitz, SD ;
Granger, CB ;
Peiper, KS ;
Lee, KL ;
Gore, JM ;
Simoons, M ;
Armstrong, PW ;
Topol, EJ ;
Califf, RM .
CIRCULATION, 1997, 95 (11) :2508-2516
[5]   Abnormal haemoglobin levels in acute coronary syndromes [J].
Bindra, K. ;
Berry, C. ;
Rogers, J. ;
Stewart, N. ;
Watts, M. ;
Christie, J. ;
Cobbe, S. M. ;
Eteiba, H. .
QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2006, 99 (12) :851-862
[6]   In-hospital prognostic value of glomerular filtration rate in patients with acute coronary syndrome and a normal creatinine level [J].
Carda Barrio, Rocia ;
de Agustin, Jose A. ;
Manzano, Maria C. ;
Garcia-Rubira, Juan C. ;
Fernandez-Ortiz, Antonio ;
Vilacosta, Isidre ;
Macaya, Carlos .
REVISTA ESPANOLA DE CARDIOLOGIA, 2007, 60 (07) :714-719
[7]   Usefulness of anemia in men as an independent predictor of two-year cardiovascular outcome in patients presenting with acute coronary syndrome [J].
Cavusoglu, Erdal ;
Chopra, Vineet ;
Gupta, Amit ;
Clark, Luther T. ;
Eng, Calvin ;
Marmur, Jonathan D. .
AMERICAN JOURNAL OF CARDIOLOGY, 2006, 98 (05) :580-584
[8]   THROMBOLYSIS IN MYOCARDIAL-INFARCTION (TIMI) TRIAL, PHASE-I - A COMPARISON BETWEEN INTRAVENOUS TISSUE PLASMINOGEN-ACTIVATOR AND INTRAVENOUS STREPTOKINASE - CLINICAL FINDINGS THROUGH HOSPITAL DISCHARGE [J].
CHESEBRO, JH ;
KNATTERUD, G ;
ROBERTS, R ;
BORER, J ;
COHEN, LS ;
DALEN, J ;
DODGE, HT ;
FRANCIS, CK ;
HILLIS, D ;
LUDBROOK, P ;
MARKIS, JE ;
MUELLER, H ;
PASSAMANI, ER ;
POWERS, ER ;
RAO, AK ;
ROBERTSON, T ;
ROSS, A ;
RYAN, TJ ;
SOBEL, BE ;
WILLERSON, J ;
WILLIAMS, DO ;
ZARET, BL ;
BRAUNWALD, E .
CIRCULATION, 1987, 76 (01) :142-154
[9]   Adverse impact of bleeding on prognosis in patients with acute coronary syndromes [J].
Eikelboom, John W. ;
Mehta, Shamir R. ;
Anand, Sonia S. ;
Xie, Changchun ;
Fox, Keith A. A. ;
Yusuf, Salim .
CIRCULATION, 2006, 114 (08) :774-782
[10]  
Goncalves PA, 2002, CIRCULATION, V106, P402